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Related Experiment Videos

Relation between Glasgow coma score and cough reflex

C Moulton1, A G Pennycook

  • 1Department of Accident and Emergency Medicine, Manchester Royal Infirmary, UK.

Lancet (London, England)
|May 21, 1994
PubMed
Summary

Comatose patients require airway assessment regardless of consciousness level. The cough reflex, crucial for safe intubation without drugs, is not reliably linked to the Glasgow Coma Scale (GCS) score.

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Area of Science:

  • Emergency Medicine
  • Critical Care Medicine
  • Neurology

Background:

  • Airway management is critical in comatose patients.
  • Endotracheal intubation without drugs can be dangerous if airway reflexes are intact.

Purpose of the Study:

  • To determine the relationship between the Glasgow Coma Scale (GCS) and airway reflex integrity in comatose patients.
  • To assess the safety of intubation without drugs in patients with varying levels of unconsciousness.

Main Methods:

  • Studied 76 comatose patients (GCS ≤ 8) in an emergency department.
  • Assessed the integrity of the cough reflex in relation to GCS scores.

Main Results:

  • The cough reflex integrity was not correlated with the GCS score in comatose patients.
  • Many patients with low GCS scores retained sufficient airway reflexes for difficult and dangerous intubation without drugs.

Conclusions:

  • Comatose patients should be presumed to have compromised airways.
  • Airway status must be evaluated independently of the patient's level of consciousness.
  • Relying solely on GCS for intubation decisions without drugs is unsafe.

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