INTRODUCTION: Pre-hospital GCS scores are used to make critical patient care decisions and to fill in gaps in hospital-based TBI surveillance, but they may not be accurate. OBJECTIVE: To determine the relationship between pre-hospital (EMS-GCS) and emergency physician GCS scores (ED-GCS). METHODS: Prospective observational study of 60 TBI patients with a field GCS of 8-13 and age > 18. ED-GCS, EMS-GCS, time of GCS and vitals signs were recorded. ANALYSIS: Simple and multiple linear regression. RESULTS: The median EMS-GCS was 13 and that for ED-GCS was 15. There was a significant linear relationship between ED-GCS and EMS-GCS (r = 0.45, p = 0.003). There was improvement in the prediction of ED-GCS when alcohol/drug use and age (but not time) were added to EMS-GCS. CONCLUSION: EMS-GCS is usually two points lower than ED-GCS, but the correlation between them is strong and independent of the time between score determinations. These results could prevent unnecessary procedures based on the EMS-GCS and improve the accuracy of TBI surveillance.
INTRODUCTION: Pre-hospital GCS scores are used to make critical patient care decisions and to fill in gaps in hospital-based TBI surveillance, but they may not be accurate. OBJECTIVE: To determine the relationship between pre-hospital (EMS-GCS) and emergency physician GCS scores (ED-GCS). METHODS: Prospective observational study of 60 TBIpatients with a field GCS of 8-13 and age > 18. ED-GCS, EMS-GCS, time of GCS and vitals signs were recorded. ANALYSIS: Simple and multiple linear regression. RESULTS: The median EMS-GCS was 13 and that for ED-GCS was 15. There was a significant linear relationship between ED-GCS and EMS-GCS (r = 0.45, p = 0.003). There was improvement in the prediction of ED-GCS when alcohol/drug use and age (but not time) were added to EMS-GCS. CONCLUSION: EMS-GCS is usually two points lower than ED-GCS, but the correlation between them is strong and independent of the time between score determinations. These results could prevent unnecessary procedures based on the EMS-GCS and improve the accuracy of TBI surveillance.
Authors: Marek Majdan; Ewout W Steyerberg; Daan Nieboer; Walter Mauritz; Martin Rusnak; Hester F Lingsma Journal: J Neurotrauma Date: 2014-11-24 Impact factor: 5.269
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Authors: Courtney Marie Cora Jones; Jeremy T Cushman; E Brooke Lerner; Susan G Fisher; Christopher L Seplaki; Peter J Veazie; Erin B Wasserman; Ann Dozier; Manish N Shah Journal: Prehosp Emerg Care Date: 2015-05-27 Impact factor: 3.077
Authors: Joshua B Brown; Raquel M Forsythe; Nicole A Stassen; Andrew B Peitzman; Timothy R Billiar; Jason L Sperry; Mark L Gestring Journal: J Trauma Acute Care Surg Date: 2014-07 Impact factor: 3.313