Classification of a traumatic brain injury: the Glasgow Coma scale is not enough
| Autor: | Eyal Russo, Carmen Martino, G. Nori, Alberto Noto, Arturo Chieregato, V. Pransani, B. Simini |
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| Rok vydání: | 2010 |
| Předmět: |
Response rate (survey)
medicine.medical_specialty medicine.diagnostic_test business.industry Traumatic brain injury Sedation Glasgow Coma Scale Poison control Physical examination General Medicine medicine.disease nervous system diseases Anesthesiology and Pain Medicine nervous system health services administration Anesthesiology Injury prevention Emergency medicine medicine sense organs medicine.symptom Intensive care medicine business hormones hormone substitutes and hormone antagonists |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 54:696-702 |
| ISSN: | 1399-6576 0001-5172 |
| DOI: | 10.1111/j.1399-6576.2010.02234.x |
| Popis: | Background: Classifying the severity of a traumatic brain injury (TBI) solely by means of the Glasgow Coma scale (GCS) is under scrutiny, because it overlooks other important clinical signs. Clinicians treating patients with acute TBI are well placed to suggest which variables, in addition to the GCS, should concur in a new classification of TBI. Methods: In Italy, acute TBI patients are treated by anaesthetists, and so we asked them, in a questionnaire survey, to rate the weight they give to the GCS and to other clinical variables in their approach to TBI. Because sedation may underestimate GCS scores, we also inquired whether anaesthetists select sedatives that allow drug-free GCS scores. The questionnaire was distributed to 1334 anaesthetists attending courses on neurotrauma; the response rate was 63%. Results: Two thirds of the respondents believe that the definition of severe TBI should include, in addition to GCS scores, pupil reactivity to light and computer tomogram (CT) findings, the variables that guide Italian anaesthetists in TBI management. Most respondents (68.2%) administer sedation which allows prompt neurological evaluation and reliable GCS scoring. A minority of respondents (9.3%) withhold or antagonize sedation, delay tracheal intubation or allow patient–ventilator asynchrony. Conclusions: Italian anaesthetists would welcome a definition of TBI severity that includes CT findings and pupil reactivity in addition to the GCS. |
| Databáze: | OpenAIRE |
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