OBJECTIVE To evaluate the validity of the FOUR (Full Outline of UnResponsiveness) score (ranging from 0 to 16), a new coma scale consisting of 4 components (eye response, motor response, brainstem reflexes, and respiration pattern), when used by the staff members of a medical intensive care unit (ICU). PATIENTS AND METHODS This interobserver agreement study prospectively evaluated the use of ...

Pharmacokinetic/pharmacodynamic (PK/PD) relationships describe the quantitative relationships between the drug-induced effects and the concurrent corresponding drug concentrations in an individual. Since a long time, rough qualitative relationships have been described between neurological presentation and plasma ethanol concentration in acute ethanol ingestion. However, to date, precise quantit...

A 62-year-old male presented to our emergency room intubated, with posttraumatic seizures and compound left femur fracture after suffering a road traffic accident. Glasgow Coma Scale (GCS) prior seizure onset was 15. The computed tomography (CT) scan magnetic resonance imaging (MRI) of the brain on admission were normal patient taken up for wound exploration fixation fracture. Postoperatively, ...

OBJECTIVE To identify in mild head injured children the major differences between those with a Glasgow Coma Scale (GCS) 15 and GCS 13/14. METHOD Cross-sectional study accomplished through information derived from medical records of mild head injured children presented in the emergency room of a Pediatric Trauma Centre level I, between May 2007 and May 2008. RESULTS 1888 patients were includ...

The Glasgow Coma Scale (GCS) has been widely adopted. Failure to assess the verbal score in intubated patients and the inability to test brainstem reflexes are shortcomings. We devised a new coma score, the FOUR (Full Outline of UnResponsiveness) score. It consists of four components (eye, motor, brainstem, and respiration), and each component has a maximal score of 4. We prospectively studied ...

Numerous scoring scales have been proposed and validated to evaluate coma for rapid pre-hospital assessment and triage, disease severity, and prognosis for morbidity and mortality. These scoring systems have been predicated on core features that serve as a basis for this review and include ease of use, inter-rater reliability, reproducibility, and predictive value. Here we review the benefits a...

PRIMARY OBJECTIVE The aim of the present study was to explore the concurrent validity, inter-rater agreement and diagnostic sensitivity of a French adaptation of the Coma Recovery Scale-Revised (CRS-R) as compared to other coma scales such as the Glasgow Coma Scale (GCS), the Full Outline of UnResponsiveness scale (FOUR) and the Wessex Head Injury Matrix (WHIM). RESEARCH DESIGN Multi-centric ...

Introduction Glasgow Coma Scale score (GCS) obtained in the hospital has been shown to predict mortality well [1]. However, the performance of GCS in the prehospital setting has not been previously studied. We hypothesized that GCS would be an adequate method for triage and for outcome prediction also when obtained prehospitally. It is crucial to identify lifethreatening emergencies in the very...

Background: Assessing patients’ level of consciousness in intensive care units (ICUs) through Full Outline Un-Responsiveness (FOUR) scale versus the Glasgow Coma Scale (GCS) requires critical nurses’ (CCNs) knowledge and skills to detect deterioration consciousness. Objectives: To evaluate effect implementing training sessions on performance perception regarding FOUR compared GCS reliability ea...