Severity grading in self-poisoning

1. The reliability and validity of three different coma scales was studied in 26 patients with acute drug overdose. 2. A comparison of six painful stimulation techniques showed that sternal rubbing and retromandibular pressure were most effective. 3. The improper use of stimulation techniques may underestimate level of responsiveness in 4-19% of cases. 4. The Reaction Level Scale (RLS) was the most reliable scale. 5. Both the RLS and the Glasgow Coma Scale may be unnecessarily complicated for the evaluation of the drug overdose patient, but should be chosen if concomitant brain injury is suspected. 6. This study confirms the basic concepts and shows the reliability of the Matthew-Lawson scale for use in the poisoned patient.