Table 2. Description of nurses’ answers from emergency service and intensive care units related to Glasgow coma scale.
| Questions | n (%) |
|---|---|
| What is the function of GCS? | |
| Evaluate level of consciousness – right answer | 126 (99.2) |
| Evaluate cognitive changes | 1 (0.8) |
| Three indicators of GCS are: | |
| Eye opening, pupil reaction, and best motor response | 1 (0.8) |
| Eye opening, best verbal response, and motor deficit | 1 (0.8) |
| Eye opening, best verbal response, and best motor response – right answer | 125 (98.4) |
| Best score for the scale is: | |
| 10 | 1 (0.8) |
| 15 – right answer | 124 (97.6) |
| 5 | 1 (0.8) |
| 8 | 1 (0.8) |
| Worse score for the scale is: | |
| 3 − right answer | 124 (97.6) |
| 4 | 1 (0.8) |
| 1 | 2 (1.6) |
| GCS score that indicates critical situation and that examiner should be alert to: | |
| GCS ≤7 | 15 (11.8) |
| GCS ≤8 − right answer | 102 (80.3) |
| GCS ≤15 | 2 (1.6) |
| GCS ≤5 | 8 (6.3) |
| To obtain accurate GCS results, the following criteria should be observed, expected: | |
| Presence of orotracheal intubation and eyelid edema | 7 (5.5) |
| Respiratory and hemodynamic stability | 4 (3.1) |
| Use of sedatives and neuromuscular blockade | 32 (25.2) |
| GCS interval that indicates moderate severity is between: | |
| 8-3 | 15 (11.8) |
| 15-13 | 4 (3.1) |
| 12-9 − right answer | 103 (81.1) |
| 14-8 | 5 (3.9) |
| During the use of GCS, the most adequate response for score is: | |
| The first response presented by the patient | 8 (6.3) |
| Best response presented by the patient − right answer | 118 (92.9) |
| Last response presented by the patient | 1 (0.8) |
| To assess eye opening, examiner should begin with: | |
| Verbally request the patient to open his/her eyes | 19 (15) |
| Call the patient’s name out loud | 57 (44.9) |
| Use painful stimuli | 1 (0.8) |
| Stand next to the patient’s bed – right answer | 50 (39.4) |
| To assess best verbal response, examiner should begin with: | |
| Marking different questions | 14 (11) |
| Simple question about localization, time, space and self – right answer | 113 (89) |
| To assess best motor response, examiner should begin with: | |
| Verbal command requesting a motor response - right answer | 114 (89.8) |
| Use of painful stimulus | 4 (3.1) |
| Observe muscle strength | 6 (4.7) |
| Observe range of movement | 3 (2.4) |
| In GCS take notes for: | |
| Only the total score | 7 (5.5) |
| Describe responses obtained | 1 (0.8) |
| Scoring each indicator | 5 (3,9) |
| Scoring each indicator, total score, and describe when necessary – right answer | 114 (89,8) |
GCS: Glasgow coma scale.