Glasgow Coma Scale

[Ridryder 911]

That is fine for your service, do you send telemetry strip as well ? I too work an aggressive Level I trauma center & I will tell you most of the time a Doc and ER personnel are usually too busy to interact very much on the radio. Usually I see lengthy detailed radio reports with new services or ones that have not built a consultation between the Doc's & staff. It is very odd these days to find detailed radio reports. A radio report > than 30 seconds is usually useless, and are used to primary assign a room.

A lot of ER's and yes even trauma centers (which I have helped developed a few) will walk away from "radio heads" ... the formal report, usually will be given upon arrival, face to face.

Be safe,

R/r 911

[Ghettomedic351]

Rid, we do send telemetry.....the thought being if you had enough concern to do a 12 lead you should transmit the EKG. And in the GCS realm I have to agree you break it down mainly when you have that so called"great concern" but not for granny with the stubbed toe. I do not consider myself a "Radio Head", kinda like on Dragnet.....Just the facts Ma'am.

[EMS49393]

No one struck a cord with me. I have my way and you have your way. I just happen to feel that my way is better. That's the beauty of our free country. I have a right to my opinions.

[Dustdevil]

I just happen to feel that my way is better. That's the beauty of our free country. I have a right to my opinions.

And you also have the responsibility to explain them.

Why is it that you "feel" your way is better?

[Lithium]

No one struck a cord with me. I have my way and you have your way. I just happen to feel that my way is better. That's the beauty of our free country. I have a right to my opinions.

And America wonders why the rest of the world hates them ... :roll:

You can 'feel' your way is better, but that doesn't actually mean it is. Do you think the person you're talking on the other end of the radio really cares that you only have ONE sick patient and are still 10 minutes away, when they proabably have a dozen or so right in front of them? I find it highly improbable.

When giving radio reports, stick to what they need to know. (Basically, do we need to have a bed ready as SOON as you guys walk in the door and where should I have the most staff? Resus/trauma?)

In all honesty, it's fairly common practice up here in my area to not even patch (radio report) to the receiving facility unless you have a critical patient being brought in. Otherwise, your dispatcher will assign you your receiving facility when you leave scene and you'll be triaged like everyone else upon arrival.

peace

[Beagle189]

When giving readio reports stick to what that receiving facility wants or what your areas policies/proceedures/protocols are. If they want a very detailed report give it to them, if they want a 30 sec or less do it in 30 seconds. Radio reports usually don't matter much anyway. Your treatment and care of the pt is what matters.

[Ghettomedic351]

However.....this post was not supposed to be about long or short radio reports but the GCS Correct???

[Beagle189]

Exactly correct ghettomedic it seems we have got off track again.

[Ghettomedic351]

I am just as guilty!

[Ace844]

Hello Everyone,

Here's a recent study on this topic...

Hope this Helps,

ACE844

(Statistical Validation of the Glasgow Coma Score.

Original Articles

Journal of Trauma-Injury Infection & Critical Care. 60(6):1238-1244 @ June 2006.

Moore, Lynne MSc; Lavoie, Andre PhD; Camden, Stephanie BSc; Le Sage, Nathalie MD, PhD; Sampalis, John S. PhD; Bergeron, Eric MD, MSc; Abdous, Belkacem PhD)

Abstract:

Background: To validate the predictive value of the Glasgow Coma Score (GCS) and find the best way to model the score in a logistic regression model predicting mortality.

Methods: Analyses were based on 20,494 patients from the trauma registries of three urban Level I trauma centers in the province of Quebec, Canada. The predictive value of the GCS and its components was evaluated in logistic regression models predicting in-hospital mortality with measures of discrimination and calibration. The performance of the GCS with no transformation and as an ordered categorical variable was compared with two transformation techniques: fractional polynomials and spline regression.

Results: The GCS had excellent discrimination (area under Receiving Operator Characteristic Curve = 0.833 95% confidence interval = 0.820-0.846) but fairly poor calibration (Pearson's Chi-squared statistic = 122 on 11 df). The eye component added no predictive information to the verbal and motor components in the whole sample but was important in certain sub-populations. Using the three components separately, rather than the sum, did not improve the predictive model. Fractional polynomial transformation of the GCS improved calibration and spline regression performed even better. GCS modeled as an ordered categorical variable performed badly both in terms of discrimination and calibration.

Conclusions: The GCS in its present form is an efficient predictor of in-hospital mortality, which could benefit from statistical transformation in logistic regression models when the accuracy of estimated probabilities of mortality is important. The common use of GCS categories for modeling mortality leads to loss of information and should be discarded.