Intensive care medicine
-
Intensive care medicine · Jan 2016
ReviewThe reliability of the Glasgow Coma Scale: a systematic review.
The Glasgow Coma Scale (GCS) provides a structured method for assessment of the level of consciousness. Its derived sum score is applied in research and adopted in intensive care unit scoring systems. Controversy exists on the reliability of the GCS. The aim of this systematic review was to summarize evidence on the reliability of the GCS. ⋯ Only 13% of studies were of good quality and inconsistency in reported reliability estimates was found. Although the reliability was adequate in good quality studies, further improvement is desirable. From a methodological perspective, the quality of reliability studies needs to be improved. From a clinical perspective, a renewed focus on training/education and standardization of assessment is required.
-
Intensive care medicine · Jan 2016
Prospective study of a proactive palliative care rounding intervention in a medical ICU.
To evaluate the effects of a palliative care intervention on clinical and family outcomes, and palliative care processes. ⋯ Proactive palliative care involvement on ICU rounds for high-risk patients was associated with more and earlier ICU family meetings and shorter hospital LOS. We did not identify differences in family satisfaction, family psychological symptoms, or family-rated quality of dying, but had limited power to detect such differences.