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[Use of Glasgow coma scale by anesthesia and intensive care internists in brain injured patients]
F Lenfant1, P Sobraquès, F Nicolas
1Département d'anesthésie-réanimation, hópital général, CHU de Dijon, France.
Objective:
To evaluate the quality and reliability of the Glasgow coma scale (GCS) score when determined, in head trauma patients, by trainees in anaesthesiology.
Study Design:
Prospective survey. USERS: One hundred trainees in their first to fourth year of training in anaesthesiology.
Methodology:
A questionnaire completed by the trainees concerning: demographic data; place, time and qualification of the physician determining the first GCS score; time and qualification of the physician determining the subsequent GCS score; assessment of the GCS score in case of asymmetrical motor response, tracheal intubation, bilateral eyelid oedema, or circulatory or ventilatory failure.
Results:
Sixty questionnaires were available for analysis. Lack of compliance with the rules for the GCS score evaluation resulted in many errors by most of the trainees. Only a few of them determined an accurate GCS score in cases of asymmetric motor response or impossibility to determine verbal or ocular response. Finally, GCS scores were determined later only very rarely.
Conclusion:
In order to provide optimal care and allow an accurate assessment of therapeutic efficiency, special attention should be given to the teaching of the GCS scoring method in head trauma patients.