The last decade has seen clarification in the definition of coma and other altered states of responsiveness (vegetative state, confusion, posttraumatic amnesia). A distinction should be made between hour to hour assessments in the acute stage, as a basis for detecting complications, and assessment on a longer timescale in order to assess the duration of coma and predicting ultimate outcome. Where standardized methods of assessment in the acute stage are used it is now possible to assess the outcome of many patients and that makes it possible to compare the results of alternative methods of management by comparing the outcome of patients whose outlook was predicted to be similar. This also requires simple and standardized classification of outcome. Such classification makes it possible to assess the economic and social impact of injury and so in turn the influence of various management methods on this. The aggregate of disability from the many mildly or moderately injured patients is probably much greater than that of the few severely injured patients who attract most attention both in the acute and in the rehabilitation phase 1.
KeywordsPublic Health Standardize Method Emergency Medicine General Hospital Clinical Assessment
- 1.Jennett B, Teasdale G (1981) Management of head injuries. F. A. Davis Company, Philadelphia, pp 361Google Scholar