Citation

Johnson VD, Whitcomb J. Dimens. Crit. Care Nurs. 2013; 32(4): 180-183.

Affiliation

Valerie D. Johnson, RN, BSN, is a Hospital Development Coordinator at LifePoint Inc. She graduated from Pensacola Christian College in 1990; worked in Medical ICU at Johns Hopkins University Hospital, ICU/CCU at St. Francis of Greenville and the Neuro/Truama ICU at Greenville Memorial Hospital and served on the nursing faculty at Bob Jones University. Her research interest is organ perfusion post recovery for more successful recipient recovery. John Whitcomb, PhD, RN, CCRN, FCCM, is assistant professor at Clemson University School of Nursing. His research focus is resuscitative outcomes.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/DCC.0b013e3182998082

PMID

23759911

Abstract

INTRODUCTION:: This study compares the Full Outline of Unresponsiveness (FOUR) Score scale with the Glasgow Coma Scale (GCS) when evaluating a patient's level of responsiveness in the neuro/trauma intensive care unit of a large medical center. This new scoring tool evaluates 4 functional categories: eye response, motor response, brainstem reflexes, and respiratory pattern. AIMS AND METHODS:: A total of 57 patients 18 years or older were randomly selected as a convenience sample of those admitted to the neuro/trauma intensive care unit and were assessed using both the standard GCS and the FOUR Score scale. The raters then completed a short survey (43 completed) to compare the 2 tools. RESULTS:: Rater agreement was very good with the FOUR Score scale and for the GCS; however, nurses favored the use of the FOUR Score scale (81.4%) over the GCS (0.00%) to assess the neurological responsiveness of their patients as the generally accepted assessment tool. CONCLUSION:: The FOUR Score scale provides a reliable neurological assessment of intubated patients where the GCS does not differentiate patient status once intubated.

Language: en