Lenfant F, Sobraquès P, Nicolas F, Combes J C, Honnart D, Freysz M
Département d'anesthésie-réanimation, hópital général, CHU de Dijon, France.
Ann Fr Anesth Reanim. 1997;16(3):239-43. doi: 10.1016/s0750-7658(97)86408-8.
To evaluate the quality and reliability of the Glasgow coma scale (GCS) score when determined, in head trauma patients, by trainees in anaesthesiology.
Prospective survey. USERS: One hundred trainees in their first to fourth year of training in anaesthesiology.
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.
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.
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.
评估麻醉科实习医生对头部外伤患者进行格拉斯哥昏迷量表(GCS)评分时的质量和可靠性。
前瞻性调查。研究对象:100名处于麻醉学培训第一年至第四年的实习医生。
实习医生填写一份问卷,内容包括:人口统计学数据;确定首个GCS评分的医生的地点、时间和资质;确定后续GCS评分的医生的时间和资质;在存在不对称运动反应、气管插管、双侧眼睑水肿或循环或呼吸衰竭情况下对GCS评分的评估。
有60份问卷可供分析。大多数实习医生因未遵守GCS评分评估规则而出现许多错误。只有少数人在存在不对称运动反应或无法确定言语或眼部反应的情况下确定了准确的GCS评分。最后,很少有GCS评分是在更晚的时候确定的。
为了提供最佳护理并准确评估治疗效果,应特别关注头部外伤患者GCS评分方法的教学。