Reliability of the Glasgow Coma Scale When Used by Emergency Physicians and Paramedics

Menegazzi, James J.; Davis, Edward H.; Sucov, Andrew; Paris, Paul M.

doi:10.1097/00005373-199301000-00008

Cited by 111 publications

(51 citation statements)

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“…The Glasgow Coma Scale (GCS) is well correlated with outcome and has good interobserver reliability, 18,21) so is widely used for the neurological assessment of head injury. However, more than 90% of patients with head injury that present to the emergency department have a GCS score of 15.…”

Section: Introductionmentioning

confidence: 99%

Indications for Computed Tomography in Patients With Mild Head Injury

Ono

Wada

Takahara

et al. 2007

Neurol. Med. Chir.(Tokyo)

137

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The factors affecting outcome were analyzed in 1,064 patients, 621 males and 443 females aged 10 to 104 years (mean 46 ± 23 years), with mild head injury (Glasgow Coma Scale [GCS] score AE14) but no neurological signs presenting within 6 hours after injury. Intracranial lesion was found in 4.7% (50/1,064), and 0.66% (7/1,064) required surgical treatment. The Japan Coma Scale (JCS) and GCS assessments were well correlated (r ＝ 0.797). Multivariate analysis revealed significant correlations between computed tomography (CT) abnormality and age AE60 years, male sex, JCS score AE1, alcohol consumption, headache, nausea/vomiting, and transient loss of consciousness (LOC)/amnesia. Univariate analysis revealed that pedestrian in a motor vehicle accident, falling from height, and mechanisms of injuries except blows were correlated to intracranial injury. No significant correlations were found between craniofacial soft tissue injury and intracranial injury. Patients with occipital impact, nonfrontal impact, or skull fracture were more likely have intracranial lesions. Bleeding tendency was not correlated with CT abnormality. The following indications were proposed for CT: JCS score À0, presence of accessory symptoms (headache, nausea/vomiting, LOC/amnesia), and age AE60 years. These criteria would reduce the frequency of CT by 29% (309/1,064). Applying these indications to subsequent patients with GCS scores 14-15, 114 of 168 patients required CT, and intracranial lesions were found in 13. Two refused CT. Fifty-four of the 168 patients did not need CT according to the indications, but 38 of the 54 patients actually underwent CT because of social reasons (n ＝ 21) or patient request (n ＝ 17). These indications for CT including JCS may be useful in the management of patients with mild head injury.

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Section: Introductionmentioning

confidence: 99%

Indications for Computed Tomography in Patients With Mild Head Injury

Ono

Wada

Takahara

et al. 2007

Neurol. Med. Chir.(Tokyo)

137

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“…A ECGl total menor ou igual a 8 pontos é comumente aceita como ponto crítico das alterações do nível de consciência e como aquela que define um indivíduo em estado de coma (RABELLO,1991;ROWLEY;FIELDING, 1991;MENEGAZZI et al,1993;MARION;CARLIER,1994;MOULTON;PENNYCOOK, 1994;SHEPHERD,1995;JUAREZ;LIONS,1995;MACRINA et al,1996;ALVES,1998).…”

Section: Fases De Um Ato De Aprendizagemunclassified

“…Sabendo-se que a ECGl é uma escala mundialmente aceita pela facilidade de aplicação, por padronizar o registro da avaliação feita pela equipe de saúde, ser precisa e forte indicador de prognóstico, além de ser uma excelente ferramenta para detectar, avaliar e quantificar rápida e precocemente alteração no nível de consciência dos pacientes (RABELLO,1991;ROWLEY;FIELDING,1991;MENEGAZZI et al,1993;MARION;CARLIER, 1994;MOULTON;PENNYCOOK, 1994;SHEPHERD,1995;JUAREZ;LIONS,1995;MACRINA et al,1996; …”

Section: Tratamento Estatísticounclassified

Ensino-aprendizagem da escala de coma de Glasgow: análise de duas técnicas em enfermeiros do serviço de emergência

Prado¹

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2001De todas as buscas humanas, a busca da sabedoria é a mais perfeita, a mais sublime, a mais útil e a mais agradável. A mais perfeita porque na medida em que o homem entrega-se à busca da sabedoria, nesta extensão ele já desfruta de alguma parcela da verdadeira felicidade. Santo Agostinho DedicatóriaAos meus pais Eduardo e Vânia, por me amarem de forma incondicional e permitirem que eu tivesse as melhores oportunidades na minha vida;Ao meu marido José Manuel, meu grande amor que aquece meu coração, por ser meu refúgio e minha fortaleza; À minha filha Laura, que ilumina e enriquece minha vida com o mais puro e verdadeiro amor; À minha irmã Silvia, por seu companheirismo e sua força espiritual, e ao meu cunhado Rui, pelas incontáveis demonstrações de carinho; À minha irmã Renata, por sua alma pura e carinhosa alegrar nossas vidas; À memória de minha avó Ruth e meu tio Filó, pelas lembranças maravilhosas ... pontos. Em relação à aquisição de conhecimentos, após serem submetidos às duas técnicas de ensino-aprendizagem, verificou-se que o Grupo 1, no global, apresentou incremento estatisticamente significativo da fase pré para a pós do processo e ele foi de 29,8%; obteve altos percentuais de acertos, em várias questões, já na fase pré e incremento de conhecimentos estatisticamente significativo, também, na maioria das questões, principalmente naquelas de aplicação prática. O Grupo 2, embora no global tenha obtido incremento estatisticamente significativo da fase pré para a pós da ordem de 8,2%, ficou inconclusivo devido à ocorrência de um importante fator interveniente, caracterizado como não leitura do texto por parte de 55,0% dos participantes. Contudo, na análise por questão, pode-se constatar que o grupo apresentou acerto em menos da metade (41,0%) das questões, na fase pré, demonstrando a precariedade da base de conhecimentos deste Grupo e a necessidade de sanar essas lacunas. Embora os resultados obtidos apontem para a superioridade da técnica de exposição oral com slides em relação à leitura dirigida, incluindo maior adesão em participar, esta conclusão deve ser interpretada com restrição, visto que a leitura para atualização não demonstrou ser uma atividade do cotidiano desses enfermeiros. AGRADECIMENTOSABSTRACT PRADO, C. Teaching-learning of the Glasgow Coma Scale -analysis of two

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“…Severity of defi cits: The severity of neurological deficits will be graded depending upon the stroke type: for ischemic stroke, the National Institute of Health (NIH) stroke scale [24,25] ; for intracerebral hemorrhage, initial Glasgow Coma Scale (GCS) [26,27] , and for subarachnoid hemorrhage, initial GCS [24,25] , Fisher grade, and Hunt and Hess grade [28] . These grades will be estimated by chart abstractors based on the initially recorded neurologic examination.…”

Section: Data Collected For the Patientsmentioning

confidence: 99%

Buffalo Metropolitan Area and Erie County Stroke Study: Rationale, Design, and Methods

et al. 2004

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Objectives: The primary objective of this study was to define the incidence, disability, and death associated with stroke in the Buffalo metropolitan area and Erie County. This area has the highest stroke rate in New York State and therefore represents an ideal site to develop a successful model for prevention and management of stroke. Design: A cross-sectional design to study all new and recurrent strokes that occurred in the calendar year 2000 in the geographical location of Buffalo metropolitan area and Erie County. Patients and Data Collected: A retrospective review of an estimated 5,000 patients with new stroke will be performed at regional hospitals and the coroner’s office to determine the stroke subtypes, cerebrovascular risk factors, diagnostic investigations, treatment provided, and outcome. The total population residing in Buffalo in the year 2000 is available through the recent census. The study will also evaluate the quality of care provided for stroke patients including effectiveness of primary and secondary stroke prevention measures within this geographical region. Conclusions: We believe that this information will assist in allocation of resources and implementation of steps to improve stroke prevention and treatment.

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Reliability of the Glasgow Coma Scale When Used by Emergency Physicians and Paramedics

Cited by 111 publications

References 0 publications

Indications for Computed Tomography in Patients With Mild Head Injury

Indications for Computed Tomography in Patients With Mild Head Injury

Ensino-aprendizagem da escala de coma de Glasgow: análise de duas técnicas em enfermeiros do serviço de emergência

Buffalo Metropolitan Area and Erie County Stroke Study: Rationale, Design, and Methods

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