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9/30/2013
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Neurosurgical patients,particularly of severe head
injuries require frequent assessment of Glasgow coma
score (GCS).
9/30/2013
As fresh residents are regularly posted in the Emergency
department (ED), there is a possibility of inter-observer
variability between the GCS assessed by Ed resident, ED
nurse & Neurosurgery resident.
 This was a prospective study carried out
over one month period from 1st June 2013
to 30th June
2013 .
 As a protocol, the GCS of head injury
patients has been observed by ED junior
residents, nurse/triage nurse and
neurosurgeons independently.
9/30/2013
9/30/2013
•
•This data was compiled for all patients
triaged as red and yellow in the study period.
9/30/2013 6
9/30/2013 7
Red =68
[60%]
Y TO R
=22
[19.29%
]
Yellow
=24
[21.05%
]
The patients whose initial GCS score
assessed by ED junior resident did not
correlate with neurosurgeons
were 32 [28.07%].
Discordance between nurses &
neurosurgeons assessment were seen in
only 5 patients [4.38%] (p<0.001).
9/30/2013
9/30/2013
 Nurses being more
experienced than
fresh junior residents
can play a vital role in
correctly assessing the
GCS of patients
coming to ED,
thereby preventing
wrong triage of
patients.
9/30/2013
9/30/2013
THANK YOU

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Inter-observer Variability in Assessing GCS in Emergency department of a level I Trauma Centre in India

  • 2. 9/30/2013 Neurosurgical patients,particularly of severe head injuries require frequent assessment of Glasgow coma score (GCS).
  • 3. 9/30/2013 As fresh residents are regularly posted in the Emergency department (ED), there is a possibility of inter-observer variability between the GCS assessed by Ed resident, ED nurse & Neurosurgery resident.
  • 4.  This was a prospective study carried out over one month period from 1st June 2013 to 30th June 2013 .  As a protocol, the GCS of head injury patients has been observed by ED junior residents, nurse/triage nurse and neurosurgeons independently. 9/30/2013
  • 5. 9/30/2013 • •This data was compiled for all patients triaged as red and yellow in the study period.
  • 7. 9/30/2013 7 Red =68 [60%] Y TO R =22 [19.29% ] Yellow =24 [21.05% ]
  • 8. The patients whose initial GCS score assessed by ED junior resident did not correlate with neurosurgeons were 32 [28.07%]. Discordance between nurses & neurosurgeons assessment were seen in only 5 patients [4.38%] (p<0.001). 9/30/2013
  • 10.  Nurses being more experienced than fresh junior residents can play a vital role in correctly assessing the GCS of patients coming to ED, thereby preventing wrong triage of patients. 9/30/2013