G C S application

Originally posted by Bruno Matos

How do you evaluate the verbal response in the patients under mechanic ventilation. It´s a major doubt in my unit.

Happy new year!

We used computarized charting and there is an entry that specifies pt is intubated. On my part, if the patient is communicating by other means (written, etc.) I include that somewhere in my notes of free verse areas in the assessment.

In the Glasgow coma scale they get a 1 or T for tubed, as it is impossible to assess neurological function accurately without guessing, which defeats the purpose!

The intubated pt automaticially gets a 1 in the verbal section of the GCS. It may be written as 'T' but it still counts as 1. This is where using the GCS falls short in the ICU setting because there are times when pts are perfectly oriented and can write down responses to questions, they just can't speak with the ETT. No matter how oriented you may know the pt is, they still get a 1 or T if intubated. As mentioned, the persons motor response becomes a better indicator in the intubated ICU pt.