In medical jargon, to be "oriented 3x" (or oriented times three) simply means to know who you are, where you are, and what time it is.
Complex questions of metaphysics, existentialism, space-time mechanics, and dasein aside, being and time in this context refers to one's ability to answer the following questions:
- What is the date?
- Where are you?
- Who are you?
Inability to answer these questions may result in findings of (or be the result of): head injury, intoxication, stroke, central nervous system infection (such as meningitis), hyperthermia, hypothermia, severe altitude illness, low blood sugar, hypoxia, dementia, poststructuralism, or a host of other interesting mental illnesses.
Following this basic assessment, the patient's level of consciousness may be graded on a scale like this:
- Oriented and can do serial addition
- Cannot do serial addition and uncertain as to date
- Disoriented by date by no more than 2 calendar days
- Disoriented by date by more than 2 calendar days
- Disoriented for place and(or) person
The level of consciousness as graded by orientation may have a corollary in the overall finding of consciousness:
- Alert: Normal response to verbal questions
- Lethargic: Drowsy, responds to raised voice
- Obtunded: Appears asleep, responds slowly after shaking
- Stuporous: Appears asleep, responds to painful stimuli only
- Comatose: Unarousable, does not respond to stimuli
Cosmo Quiz for the Girlfriend in a Coma
If the patient is found to be comatose, he or she will be scored for treatment using the Glascow Coma Scale, which was developed in 1974 as an assessment tool for patients with altered levels of consciousness.
The Glascow Coma Scale
Eye Opening
4: spontaneous eye opening
3: eye opening to verbal command
2: eye opening to painful stimulation
1: no eye opening
Best Motor Response
6: obeys verbal commands
5: localizes painful stimuli (brushes away with hand)
4: withdraws in flexion pattern from painful stimuli
3: flexion posture in response to painful stimuli
2: extension posture in response to painful stimuli
1: no response to painful stimuli
Best Verbal Response
5: oriented to time, place and person, and conversant
4: disoriented and conversant
3: inapproriate word usage
2: incomprehensible sounds
1: no verbal output
Add the numerical score for each of three groups to obtain Glascow Coma Score.
A score of 8 or less is the accepted definition of the comatose patient. Severe head injury is therefore associated with a GCS less than or equal to 8, moderate head injury a GCS of 9 to 12, and a mild head injury a GCS of 13 to 15.
Additional uses: Best Verbal Response is also a useful way to grade first dates.