February 4, 2016 - Emergency Situations

Question 1

Glasgow Coma Scale

Answer 1

Provides a baseline for LOC for future comparisons and has been shown to correlated with outcome for many cases. You should consider intubation if the patient scores less than 8 on the GCS.

Eye Opening - Spontaneous (4), to loud voice (3), to pain (2), none (1)

Verbal Response - Orientated (5), confused/disorientated (4), inappropriate words (3), incomprehensible sounds (2), none (1)

Motor Response - Obeys commands (6), localizes (5), withdraws (4), abnormal flexion position (3), extension posturing (2), none (1)

Question 2

Indications for Intubation

Answer 2

1) Hypoxemia despite maximal non-invasive oxygen therapy
2) Inadequate ventilation (increased PCO₂)
3) Need to control/remove pulmonary secretions
4) Need to provide airway protection