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Published on: January 16, 2019
The Glasgow Coma Scale in intensive care: a study.
T Price1, L Miller, M deScossa
1Department of Nursing, Faculty of Health and Social Care, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton, Bristol. theresa.price@uwe.ac.uk
Nursing in Critical Care
|March 10, 2001
Summary
The Glasgow Coma Scale may not be suitable for assessing neurological changes in sedated, ventilated patients with severe brain injuries. Its use in this patient population requires careful consideration due to limited correlation with key neurological indicators.
Area of Science:
- Neurology
- Critical Care Medicine
- Neurotrauma
Background:
- Neurological assessment is crucial for patients with severe cerebral insults.
- Intubated, sedated, and ventilated patients present unique challenges for neurological evaluation.
- The Glasgow Coma Scale (GCS) is a standard tool, but its utility in this specific population is debated.
Purpose of the Study:
- To evaluate the effectiveness of the Glasgow Coma Scale in detecting neurological changes in sedated, ventilated adult patients.
- To determine if alterations in GCS scores prompted changes in therapeutic interventions.
- To assess the correlation between GCS parameters and intracranial perfusion pressure (ICP) in this patient group.
Main Methods:
- Retrospective analysis of patient observation records.
- Inclusion criteria: adult, intubated, sedated, ventilated patients with severe cerebral insult.
- Descriptive statistics were used to analyze the collected data.
Main Results:
- The Glasgow Coma Scale did not predict or correlate with sustained increases in intracranial perfusion pressure (ICP).
- Therapeutic interventions were modified based on various parameters, not solely GCS changes.
- No significant correlation was found between GCS scores and ICP trends in the analyzed cohort.
Conclusions:
- The Glasgow Coma Scale may not be an appropriate neurological assessment tool for intubated, sedated, and ventilated patients.
- Clinical decisions regarding therapeutic interventions in these patients are multifactorial.
- Further research is needed to identify reliable neurological assessment methods for critically ill, sedated patients.
