Title
Lack of standardization in the use of the Glasgow coma scale : results of international surveys Lack of standardization in the use of the Glasgow coma scale : results of international surveys
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
New York ,
Subject
Human medicine
Source (journal)
Journal of neurotrauma. - New York
Volume/pages
33(2016) :1 , p. 89-94
ISSN
0897-7151
ISI
000367057200011
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
The Glasgow Coma Scale (GCS) was introduced 40 years ago and has received world-wide acceptance. The GCS rates eye, motor, and verbal responses to assess the level of consciousness. Concerns have been expressed with regard to reliability and consistency of assessments. We considered that lack of standardization in application techniques and reporting of the GCS may have contributed to these concerns, and aimed to assess current procedures in its use. Questionnaire-based assessments were conducted by an online survey and during neurosurgical training courses. Overall, 616 participants were recruited, representing 48 countries and including physicians and nurses from different disciplines. Use of the GCS was reported by nearly all participants for assessment of patients with traumatic brain injury, but not for all patients with a reduced level of consciousness from other causes (78%). Major differences were found regarding the type of stimulus applied when patients do not obey commands: Nail bed pressure, supraorbital pressure, trapezius or pectoralis pinch, and sternal rub were all frequently used, whereas 25% of responders reported to never use a peripheral stimulus. Strategies for reporting the GCS varied greatly, and 35% of participants limited the reporting to a summary score. Moreover, different approaches were used when one of the components could not be assessed. Overall, the surveys have identified a general lack of standardization in assessment and reporting of the GCS. The results illustrate the need for continued education to improve reliability of assessments through guidance to a standard approach.
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https://repository.uantwerpen.be/docman/iruaauth/60fc5b/131052.pdf
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Full text (open access)
https://repository.uantwerpen.be/docman/irua/abeac4/131052.pdf
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