Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-28T03:30:46.308Z Has data issue: false hasContentIssue false
  • English
  • Français

Effectiveness of a Glasgow Coma Scale Instructional Video for EMS Providers

Published online by Cambridge University Press:  28 June 2012

Peter L. Lane ,
Amado Alejandro Báez ,
Thomas Brabson ,
David D. Burmeister  and
John J. Kelly
Peter L. Lane*
Affiliation:
Departments of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
Amado Alejandro Báez
Affiliation:
Department of Emergency Medicine, Mayo Graduate School of Medicne, Rochester, Minnesota, USA
Thomas Brabson
Affiliation:
Departments of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
David D. Burmeister
Affiliation:
Western Pennsylvania Hospital, Pittsburgh, Pennsylvania, USA
John J. Kelly
Affiliation:
Departments of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
*
Department of Emergency Medicine, Albert Einstein Medical Center, Korman B-6, 5501 Old York Road, Philadelphia, PA 19141 USA, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

The Glasgow Coma Scale (GCS) is the standard measure used to quantify the level of consciousness of patients who have sustained head injuries. Rapid and accurate GCS scoring is essential.

Objective:

To evaluate the effectiveness of a GCS teaching video shown to prehospital emergency medical services (EMS) providers.

Methods:

Participants and setting—United States, Mid-Atlantic region EMS providers. Intervention—Each participant scored all of the three components of the GCS for each of four scenarios provided before and after viewing a video-tape recording containing four scenarios. Design—Before-and-after single (Phase I) and parallel Cohort (Phase II). Analysis— Proportions of correct scores were compared using chi-square, and relative risk was calculated to measure the strength of the association.

Results:

75 participants were included in Phase I. In Phase II, 46 participants participated in a parallel cohort design: 20 used GCS reference cards and 26 did not use the cards. Before observing the instructional video, only 14.7% score all of the scenarios correctly, where as after viewing the video, 64.0% scored the scenarios results were observed after viewing the video for those who used the GCS cards (p = 0.001; RR = 2.0; 95% CI = 1.29 to 3.10) than for those not using the cards (p <0.0001; RR = 10.0; 95% CI = 2.60 to 38.50).

Conclusions:

Post-video viewing scores were better than those observed before the video presentation. Ongoing evaluations include analysis of longterm skill retention and scoring accuracy in the clinical environment.

Keywords

audio-visual aidseducational modelemergency medical servicesGlasgow Coma Scaleinstructiontrauma
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 17 , Issue 3 , September 2002 , pp. 142 - 146
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Teasdale, G, Jennett, B: Assessment of coma and impaired consciousness. A practical scale. Lancet 1974;2:81–84.Google Scholar
2.Teasdale, G, Jennett, B: Assessment and prognosis of coma after head injury. Acta Neurochir (Wien) 1976; 34(1–4):45–55.Google Scholar
3.Chesnut, RM: The management of severe traumatic brain injury. Emerg Med Clin North Am 1997;15(3):581–604.CrossRefGoogle Scholar
4.Gormican, SP: CRAMS scale: Field triage of trauma victims. Ann Emerg Med 1982; 1(3):132–135.Google Scholar
5.Boyd, CR, Tolson, MA, Copes, WS: Evaluating trauma care: The TRISS method. Trauma Score and the Injury Severity Score. J Trauma 1987; 27(4): 370–378.CrossRefGoogle ScholarPubMed
6.Knaus, WA, Zimmerman, JE, Wagner, DP, Draper, EA, Lawrence, DE: APACHE-acute physiology and chronic health evaluation: A physiologically based classification system. Crit Care Med 1981;9(8):591–597.Google Scholar
7.Jennett, B, Teasdale, G, Braakman, R, Minderhoud, J, Knill-Jones, R: Predicting outcome in individual patients after severe head injury. Lancet 1976;1(7968):1031–1034.CrossRefGoogle Scholar
8.Bastos, PG, Sun, X, Wagner, DP, Wu, AW, Knaus, WA: Glasgow Coma Scale score in the evaluation of outcome in the intensive care unit: Findings from the Acute Physiology and Chronic Health Evaluation III study. Crit Care Med 1993;10:1459–1065.CrossRefGoogle Scholar
9.White, JR, Farukhi, Z, Bull, C, Christensen, J, Gordon, T, Paidas, C, Nichols, DG: Predictors of outcome in severely head-injured children. Crit Care Med 2001;29(3):534–540.Google Scholar
10.Winkler, JV, Rosen, P, Alfry, EJ: Prehospital use of the Glasgow Coma Scale in severe head injury. J Emerg Med 1984;2(1):1–6.Google Scholar
11.Committee on Trauma, American College of Surgeons (ACS): Resources for the Optimal Care of the Injured Patient: 1999. Chicago: American College of Surgeons, 1998.Google Scholar
12.Champion, HR, Sacco, WJ, Camazzo, AJ, Copes, W, Fouty, WJ:Trauma score. Crit Care Med 1981;9(9):672–676.CrossRefGoogle ScholarPubMed
13.Champion, HR, Sacco, WJ, Copes, WS, Gann, DS, Gennarelli, TA, Flanagan, ME: A revision of the Trauma Score. J Trauma 1989;29(5):623–629.CrossRefGoogle ScholarPubMed
14.Crossman, J, Bankes, M, Bhan, A, Crockard, HA: The Glasgow Coma Score: Reliable evidence? Injury 1998;29(6):435–437.CrossRefGoogle ScholarPubMed
15.Menegazzi, JJ, Davis, EA, Sucov, AN, Paris, PM: Reliability of the Glasgow Coma Scale when used by emergency physicians and paramedics. J Trauma 1993;34(1):46–48.CrossRefGoogle ScholarPubMed
16.Juarez, VJ, Lyons, M: Interrater reliability of the Glasgow Coma Scale. J Neurosci Nurs 1995;27(5):283–286.Google Scholar
17.Rowley, G, Fielding, K: Reliability and accuracy of the Glasgow Coma Scale with experienced and inexperienced users. Lancet 1991;337(8740):535–538.Google Scholar
18.Braakman, R, Avezaat, CJ, Maas, AI, Roel, M, Schouten, HJ: Inter-observer agreement in the assessment of the motor response of the Glasgow “Coma” Scale. Clin Neurol Neurosurg 1977;80(2):100–106.CrossRefGoogle ScholarPubMed