I actively avoid the term "lethargic." First, it apparently has serious connotations to MDs and second because it doesn't tell me anything in particular. I chart...pt responds slowly to questions, appears to fall asleep during triage process, needs to be asked question over and over in order to participate in triage process, responds to sternal rub only, etc. Give the pt a GCS score at the end of triage note for better assessment
I would avoid its use as well. It's too subjective and open to interpretation. One person's "lethargic" might be another person at baseline. Instead, I would describe specific behaviors, such as whether their eyes are open, whether they respond to voice, whether they follow commands, whether they answer questions appropriately, etc.