兒童意識狀態紀錄表 (兩歲以內) 第_{____}頁

姓名 病例號碼 床號 年齡

日 期
時 間
C O M A S C A L E	Eyes Open	Spontaneously 4
		To shout 3
		To pain 2
		None 1
	Best Verbal Response	Smile,coos appropriate 5
		Cries, consolable 4
		Persistent inappropriate crying/screaming 3
		Grunt,agitated, restless 2
		No response 1
	Best Motor Response	Sontaneous 6
		Wthdraw to touch 5
		Wthdraw to pain 4
		Flexion-abnormal,Decroticated 3
		Extension, decerebrated 2
		No response 1
Pupil Size in mm		Pupil + react - none C close	R	size
				reaction
			L	size
				reaction
		M O T O R	A R M S	Muscle Power=5
				Muscle Power=4
				Muscle Power=3
				Muscle Power=2
				Muscle Power=1
			L E G S	Muscle Power=5
				Muscle Power=4
				Muscle Power=3
				Muscle Power=2
				Muscle Power=1