The COHMC (Children's Orthopedic Hospital and Medical Center, Seattle, Washington) coma scale can be used to assess children with a variety of central nervous system injuries. Since verbalization is not assessed, it can be used with preverbal or previously intubated children.
Function
Findings
Score
cortical function subtotal
purposeful, spontaneous movements
6
purposeful, voice-evoked movements
5
painful stimulus localized
4
nonpurposeful movements, global withdrawal
3
decorticate posturing
2
decerebrate posturing
1
flaccid
0
brainstem function subtotal
intact (pupillary light reflex, corneal reflex and oculovestibular or oculocephalic reflexes present and normal)
3
depressed (pupillary light reflex, corneal reflex and oculovestibular or oculocephalic reflexes delayed or diminished, or some reflexes present while others absent)
2
absent but breathing spontaneously
1
absent and apneic (with normal PaCO2)
0
COHMC coma scale =
= (cortical function subtotal) + (brainstem function subtotal)
Interpretation:
• minimum score: 0 (poor)
• maximum score: 9 (good)
• mortality very high for children with scores < 3
• no children admitted with flaccidity survived
To read more or access our algorithms and calculators, please log in or register.
