Standardizing neurological assessments.

Evaluation of neurological status is imperative to patient assessment. Multiple assessment tools are readily available for clinicians to diagnose and report changes in neurological condition. Some of these tools include the Glasgow Coma Scale, the National Institutes of Health Stroke Scale, the Canadian Neurological Scale, and the Four Score. Although assessment tools are beneficial to help standardize the assessment and communication of findings, they are at times cumbersome, leaving bedside clinicians with questions concerning which tool is appropriate for a given patient population. This initiative began as a means to standardize assessments and communication for neuroscience patients. As success was met, the project was moved forward locally at our hospital campus and later extended to the entire health system. With the support of the chief of neurology, the neuroscience patient care services director, the stroke coordinator, and the neuroscience clinical educator, three different neurological examinations were developed. They were defined as the Basic Neurological Check, the Coma Neurological Check, and the National Institutes of Health Stroke Scale/Stroke Neurological Check. The neurological examinations would address the assessment needs of patients with acute stroke, general neurosurgery/neurology patients, and patients in coma.

Making GCS as easy as 1, 2, 3, 4, 5, 6.

The Glasgow Coma Scale (GCS) is an easy to use tool for assessing neurological function and brain injury in comatose patients particularly in acute stages of traumatic injury or illness. Due to the simplicity of the scale, however, proper training is often overlooked limiting its usefulness. This manuscript describes the basic components of the GCS and the proper scoring method to elicit accurate evaluations.