PMID: 9436740Jan 22, 1998Paper

Measurement of impaired consciousness in the neurological intensive care unit: a new test

Journal of Neurology, Neurosurgery, and Psychiatry
Eelco F M WijdicksP C O'Brien

Abstract

Neurological deterioration in alert patients with an acute CNS disorder can be subtle, but current coma scales may not clearly capture changes in level of alertness. Many coma scales include components such as eye opening and content of speech, features that are difficult to assess in intubated patients and patients with facial trauma. Two new tools have been devised by the authors. The components are a continuous performance test (patient is asked to raise his hand every time he hears a certain letter in a standardised sentence) and the three consecutive hand position test ("thumbs up-fist-victory sign"). Variation within and between observers was assessed with three neurologists, two junior neurology residents, and two neuroscience nurses, and compared with the Glasgow coma score. The average agreements had comparable ranges for both scores, 65% to 89% for both tests and 60% to 88% for the Glasgow coma score. On the first visit 49% of all tests with a maximum Glasgow coma score had a negative continuous performance test as opposed to 13% of tests with a less than maximum Glasgow coma score. For the consecutive hand position test, these numbers were respectively 25% and 2%. These tests may be a reasonable alternative to the Gl...Continue Reading

Associated Clinical Trials

Citations

Jul 24, 2010·Neurocritical Care·Joshua Kornbluth, Anish Bhardwaj
Aug 23, 2003·Journal of Neurology, Neurosurgery, and Psychiatry·Saif S M Razvi, Ian Bone
Dec 26, 2009·Neurologia Medico-chirurgica·Phuping Akavipat
Mar 20, 2009·Revue neurologique·N WeissF Bolgert
Nov 14, 2015·Intensive Care Medicine·Florence C M ReithAndrew I R Maas
Sep 16, 2016·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Kishor KhanalModa Nath Marhatta
Aug 22, 2008·Palliative Medicine·F GonçalvesL Costa
Sep 24, 2005·Annals of Neurology·Eelco F M WijdicksRobyn L McClelland
Mar 23, 2017·Neurosurgery·Florence Cm ReithAndrew Ir Maas
Mar 10, 2007·British Journal of Nursing : BJN·Rachel Palmer, Jessica Knight
May 23, 2020·Minerva anestesiologica·Nicolas Gaspard

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