scholarly journals An observational study on use of Glasgow coma scale in neurology patients among staff nurses of the intensive care units and emergency departments in selected hospitals at Mangaluru

2021 ◽  
Vol 09 (07) ◽  
Author(s):  
Mrs. Jonita Wilma Rodrigues ◽  
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Glasgow Coma Scale ◽  
Intensive Care Units ◽  
Emergency Departments ◽  
Staff Nurses ◽  
Coma Scale

Comparison of the Full Outline of Unresponsiveness (FOUR) Score with the Glasgow Coma Scale (GCS) as a Coma Assessment Scale in Pediatric Intensive Care

2021 ◽  
Author(s):  
Merve Misirlioglu ◽  
Dincer Yildizdas ◽  
Faruk Ekinci ◽  
Ozden Ozgur Horoz ◽  
Gulen Gul Mert
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Glasgow Coma Scale ◽  
Intensive Care Units ◽  
Rapid Assessment ◽  
Pediatric Intensive Care ◽  
Coma Scale ◽  
Additional Information ◽  
Ventilation Monitoring ◽  
Four Score

AbstractRapid assessment of cerebral dysfunction is crucial for the management of patients in intensive care units. The Glasgow Coma Scale (GCS) evaluates eye, verbal, and motor responses, but is insufficient to effectively evaluate patients on mechanical ventilation, or who are unable to speak. The Full Outline of Unresponsiveness (FOUR) score includes additional information such as brainstem reflexes and respiratory status to provide a more complete clinical assessment. In this study, we aimed to compare the FOUR score with GCS in the assessment of patients with coma. This prospective study included patients between 1 month and under 18 years of age, who were hospitalized in the pediatric intensive care unit due to risk of coma or ongoing impairment of consciousness between May 2018 and June 2019. Information regarding FOUR scores, GCS values, patient demographics, duration of hospitalization, requirement for mechanical ventilation, and patient comorbidities were recorded and analyzed. Among the 80 patients included in the study, a statistically significant correlation was found between (low) GCS and FOUR scores during admission, and mortality and requirement for mechanical ventilation. Monitoring the level of consciousness is important in pediatric intensive care units and may be predictive of the course and disease outcome. Similar to the GCS, the FOUR score is a good indicator for predicting mortality and requirement for mechanical ventilation.

scholarly journals Tradução e Validação da Escala FOUR para a Pediatria e o seu Uso Como Indicador Prognóstico: Um Estudo Piloto

2017 ◽  
Vol 30 (9) ◽  
pp. 599 ◽  
Author(s):  
Sofia Simões Ferreira ◽  
Daniel Meireles ◽  
Alexandra Pinto ◽  
Francisco Abecasis
Keyword(s):  
Intensive Care ◽  
Glasgow Coma Scale ◽  
Intensive Care Units ◽  
Adult Population ◽  
Strong Association ◽  
Pediatric Intensive Care ◽  
Impaired Consciousness ◽  
Pediatric Intensive Care Units ◽  
Coma Scale ◽  
Minimum Score

Introduction: The Full Outline of UnResponsiveness - FOUR scale has been previously validated to assess impaired consciousness in the adult population. The aim of this study is the translation into Portuguese and validation of the FOUR scale in the pediatric population. The study also compares the FOUR scale and Glasgow coma scale score ratings and the clinical outcome of patients hospitalized in Pediatric Intensive Care Units.Material and Methods: This study prospectively rated patients admitted to the Pediatric Intensive Care Units with impaired consciousness during one year. Both scales were applied daily to patients by three types of examiners: intensivists, residents and nurses, from the moment of admission until clinical discharge. Neurological sequelae was evaluated using the King’s Outcome Scale for Childhood Head Injury - KOSCHI.Results: Twenty seven patients between one and 17 years of age were included. Both scales are reliable and inter-rater reliability was greater for the FOUR score. Glasgow coma scale showed a minimum score in eight evaluations, whereas the FOUR scale obtained the minimum score in only two of these evaluations. In both scales there was a strong association between the admission score and the patient’s outcome (area under curve FOUR = 0.939, versus Glasgow coma scale = 0.925).Discussion: The FOUR scale provides more neurological information than Glasgow coma scale in patients with impaired consciousness and has prognostic interest.Conclusion: The FOUR scale can be applied in patients admitted with impaired consciousness in Pediatric Intensive Care Units. We think that a multicenter study would be very beneficial for confirming and generalizing these results.

scholarly journals Inappropriateness of Antibiotic Prescribing in Medical, Surgical and Intensive Care Units: Results of a Multicentre Observational Study

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 475
Author(s):  
Margherita Macera ◽  
Federica Calò ◽  
Lorenzo Onorato ◽  
Giovanni Di Caprio ◽  
Caterina Monari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Intensive Care Units ◽  
Case Report Form ◽  
Antibiotic Prescribing ◽  
Duration Of Treatment ◽  
Campania Region ◽  
Stewardship Program ◽  
Surgical Units ◽  
Set Up

The objectives of the present study were to provide a snapshot analysis of antibiotic appropriateness in two hospitals in Southern Italy in three specific areas, surgical, medical and intensive care, and to evaluate the risk factors associated with inappropriateness in antimicrobial prescriptions. We conducted a multicentre observational study in two hospitals in the Campania region. We collected data of all patients admitted on the day of evaluation to antibiotic therapy or prophylaxis through a case report form. The primary outcome was to assess the inappropriateness of antibiotic prescribing, related to the spectrum, dose, route of administration and duration of treatment—in particular, to assess whether there was a difference in the adequacy of the prescriptive practice in the medical, surgical and intensive sectors. Prescriptive inappropriateness was more frequently observed in surgical units (79.8% of the 104 antimicrobial prescriptions) than in medical units (53.8% of the 65 prescriptions, p = 0.0003) or in intensive care units (64.1% of the 39 prescriptions, p = 0.052). The reasons for the inappropriate antimicrobial prescriptions were similar in the three areas evaluated: antimicrobial unnecessary and antimicrobial not recommended were the most frequent reasons for inappropriateness. Not participating in an antimicrobial stewardship program (ASP) was identified as a factor associated with inappropriate antimicrobial prescriptions in medical and surgical units, but not in Intensive Care Units (ICUs). ASPs may enhance the appropriateness of antimicrobial prescriptions especially in medical and surgical units. In ICUs, specific programs able to limit empirical therapies and encourage the collection of microbiological samples may be useful to set up targeted therapies and to design antimicrobial protocols.

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