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FOUR Score Coma Exam

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1. FOUR Score Coma Exam

Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "FOUR Score Coma Exam." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Examination About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided (...) FOUR Score Coma Exam FOUR Score Coma Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 FOUR Score Coma Exam FOUR Score Coma Exam

2018 FP Notebook

2. FOUR Score Coma Exam

Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "FOUR Score Coma Exam." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Examination About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided (...) FOUR Score Coma Exam FOUR Score Coma Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 FOUR Score Coma Exam FOUR Score Coma Exam

2017 FP Notebook

3. European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness Full Text available with Trip Pro

Coma Scale (GCS) for the classification of DoC patients in the ICU ( n = 313) - . Relative risk for evidence of consciousness detected by the FOUR compared to the GCS was 1.46 (95% CI 1.04–2.05; P = 0.03). Recommendation: The task force group recommends that the FOUR score be used to assess the level of consciousness in patients with DoC in the ICU instead of the GCS ( moderate evidence, strong recommendation ). Although less sensitive than the CRS‐R, the FOUR score is more convenient for frequent (...) by the examiner); relying on repeated rather than isolated clinical assessments (preferentially using the CRS‐R); favoring the FOUR score over the GCS in the acute setting; and visual analysis of standard EEG, including searching for REM and slow‐wave sleep patterns. There is a wealth of other clinical bedside markers that were excluded here due to lack of sufficient data but that nevertheless appear promising. These include searching for resistance to eye opening , command following using automated

2020 European Academy of Neurology

4. European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

]. Recommendation: The classi?cation of conscious- ness levels should never be made based on an isolated assessment (low evidence, strong recommendation). PICO 6 Should the Full Outline of Unresponsive- ness (FOUR) score be used to diagnose the level of consciousness in patients with DoC in the ICU? Three studies compared the FOUR [67] with the Glas- gow Coma Scale (GCS) [79] for the classi?cation of DoC patientsintheICU(n = 313)[61–63].Relativeriskforevi- dence of consciousness detected by the FOUR compared (...) - longed DoC is still limited but increasing. Impor- tantly, low-cost and easy-to-implement bedside measures can have immediate clinical impact. A few of these have been highlighted, including the impor- tance of probing for voluntary eye movements using a mirror (if necessary after passive eye opening by the examiner); relying on repeated rather than isolated clinical assessments (preferentially using the CRS-R); favoring the FOUR score over the GCS in the acute setting; and visual analysis

2020 European Academy of Neurology

5. Reliability of Robotic Telemedicine for Assessing Critically Ill Patients with the Full Outline of UnResponsiveness Score and Glasgow Coma Scale Full Text available with Trip Pro

, traditionally employed at the bedside for remote assessment, are largely lacking.Bedside and remote assessments of patients with decreased LOC, using either the Glasgow Coma Scale (GCS) or Full scale Of UnResponsiveness (FOUR), score are equivalent.Prospective trial comparing the reliability of bedside and remote coma assessments using GCS or FOUR score clinical evaluation tools utilizing robotic telepresence technology. Total scores of the GCS and FOUR score were compared between bedside and remote (...) physician assessors by paired t-test and Pearson correlation coefficient (PCC).One hundred subjects were enrolled. Mean age was 70.8 (±15.9) years and the average examination time took 5.16 (±2.04) minutes. Mean GCS total score at bedside was 7.5 (±3.67) versus examination conducted remotely 7.23 (±3.85); difference in scores was 0.25 (±0.10); p = 0.01. Mean FOUR total score at bedside was 9.63 (±4.76) versus remote 9.21 (±4.74); difference in scores was 0.40 (±2.00); p = 0.05. PCC for GCS was 0.966; p

2017 Telemedicine Journal and e-Health

6. Glasgow Coma Scale for Field Triage of Trauma: A Systematic Review

trauma, what is the predictive utility of the total Glasgow Coma Scale compared with the motor component of the Glasgow Coma Scale for predicting in-hospital mortality, morbidity, injury severity score of 16 or greater, head Abbreviated Injury Scale (AIS) score greater than 2 (AIS-2005) or greater than 3 (AIS- 1998), presence of intracranial hemorrhage, and utilization indicators of severe injury (e.g., receipt of intracranial monitoring within 48 hours of admission, receipt of a neurosurgical (...) (components): eye (scored 1 to 4), verbal (scored 1 to 5), and motor (scored 1 to 6). Scores on each of these components are added to obtain the total Glasgow Coma Scale (tGCS) score, ranging from 3 to 15. Lower scores on the tGCS indicate lower levels of consciousness, generally correlating with more severe injury associated with poorer prognosis and requiring more intensive care. For patients with TBI, scores of 3 to 8 are generally considered to denote severe head injury, 9 to 12 moderate, and 13 to 15

2017 Effective Health Care Program (AHRQ)

7. Whole-Body CT after Motor Vehicle Crash: No Benefit after High-Energy Impact and with Normal Physical Examination. (Abstract)

motor vehicle crash (MVC) meeting only kinetic elements of the Vittel criteria for the severity of trauma, with no evidence of trunk injury and a Glasgow Coma Scale score of 15. Materials and Methods This retrospective study included all consecutive adult patients who consulted an emergency department of a level 1 trauma center between August 2016 and July 2017 if they underwent whole-body CT for one or more kinetic elements of the Vittel criteria, had a normal examination of the trunk, and had (...) a Glasgow Coma Scale score of 15. Data of the MVC mechanism and physical and biologic examinations were collected, as well as patient treatment data after whole-body CT. Whole-body CT examinations were read by two double-blinded readers to help detect unsuspected injuries. Results Ninety-three patients were included; 72 were men with a mean age of 30.8 years ± 12.0 (standard deviation). Sixty-nine patients were occupants of a car. Seventeen patients were hit by a car while on motorbikes, three while

2019 Radiology

8. High on drugs: Multi-institutional pilot study examining the effects of substance use on acute pain management. (Abstract)

with vehicular trauma over four months (n = 176). We examined the effect of positive urine drug screen (UDS; 7-drug panel, examined individually and combined, yes/no) and positive blood alcohol content (BAC, ≥80 mg/dL) on pain management with opioid analgesics over the hospital stay. Average daily opioid consumption was examined using a repeated measures mixed model, by positive UDS and BAC findings, adjusting for age, injury severity score, and non-opioid analgesia. Opioid analgesics were converted (...) High on drugs: Multi-institutional pilot study examining the effects of substance use on acute pain management. Substance use and abuse may have the significant, but unanticipated, consequence of lessening the efficacy of opioid analgesics for acute pain management. We hypothesized that pre-injury substance use increases opioid analgesic consumption following traumatic injury.This retrospective multi-institutional pilot study included admitted patients to four level 1 trauma centers

2019 Injury

9. National Early Warning Score

of evidence linked to each recommendation. 2.1 Essential elements These elements describe the essential features of the systems of care required to implement the NEWS System, (using the VitalPAC™ Early Warning Score (ViEWS) Parameters) and the NEWS escalation protocol, to recognise and respond to clinical deterioration. Four elements relate to clinical processes that need to be locally delivered, and are based on the circumstances of the acute hospital in which care is provided. A further three elements (...) National Early Warning Score National Early Warning Score National Clinical Guideline No. 1 February 2013The National Early Warning Score and COMPASS © Education programme project is a work stream of the National Acute Medicine Programme, HSE, in association with the National Critical Care Programme, HSE, the National Elective Surgery Programme, HSE, the National Emergency Medicine Programme, HSE, the Quality and Patient Safety Directorate, HSE, Patient Representative Groups, Nursing

2019 National Clinical Guidelines (Ireland)

10. Brain Network Disruptions Related to Traumatic Coma

to consciousness (RECUP), vegetative neurological state (ENV) or minimal state of consciousness (ECM). This scale has been validated in French, with a value of Cronbach's Alpha estimated at 0.8. It is a score whose values are between 100 (normal level of consciousness) and 10 (coma). ENV and ECM have intermediate values (approximately 30 and 60, respectively). FOUR score [ Time Frame: 3 months +/- 3 days after the primary brain insult ] The FOUR score is a scale of 4 items and 16 points concerning qualitative (...) and positron emission tomography (PET) scan (neuroinflammation ligands). Condition or disease Intervention/treatment Phase Traumatic Coma Radiation: PET examination with radiopharmaceutical drug [18F] DPA-714 Diagnostic Test: MRI examination Biological: Blood samples Not Applicable Detailed Description: So far, the gold standard for neuroprognostication of severe traumatic brain injury (TBI) or anoxic encephalopathy is the bedside behavioural evaluation. Nevertheless, the predictive value

2018 Clinical Trials

11. FOUR score and Glasgow Coma Scale in predicting outcome of comatose patients: a pooled analysis (Abstract)

FOUR score and Glasgow Coma Scale in predicting outcome of comatose patients: a pooled analysis 21562252 2011 09 02 2011 07 05 1526-632X 77 1 2011 Jul 05 Neurology Neurology FOUR score and Glasgow Coma Scale in predicting outcome of comatose patients: a pooled analysis. 84-5 10.1212/WNL.0b013e318220ac06 Wijdicks Eelco F M EF Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. wijde@mayo.edu Rabinstein Alejandro A AA Bamlet William R WR Mandrekar Jay N JN eng (...) Journal Article Research Support, Non-U.S. Gov't 2011 05 11 United States Neurology 0401060 0028-3878 AIM IM Adult Aged Aged, 80 and over Area Under Curve Cohort Studies Coma diagnosis physiopathology Comprehension Eye Movements Female Glasgow Coma Scale Humans Male Middle Aged Physical Examination methods Predictive Value of Tests Prognosis ROC Curve Reflex Respiration 2011 5 13 6 0 2011 5 13 6 0 2011 9 3 6 0 ppublish 21562252 WNL.0b013e318220ac06 10.1212/WNL.0b013e318220ac06

2011 EvidenceUpdates

12. Validation of the Russian Version of Coma Recovery Scale-Revised (CRS-R)

evaluation of the content of CRS-R by the investigators. Сriterion validity will be examined by assessing the correlations of CRS-R with the scales of other questionnaires with proven high psychometric properties for consciousness disorders: the Glasgow Coma Scale and Full Outline of UnResponsiveness (FOUR) score. Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 60 participants Observational Model: Cohort Time Perspective: Cross-Sectional Official Title (...) : Validation of the Russian Version of Coma Recovery Scale-Revised (CRS-R) Actual Study Start Date : November 1, 2016 Actual Primary Completion Date : July 12, 2017 Actual Study Completion Date : July 12, 2017 Resource links provided by the National Library of Medicine related topics: Groups and Cohorts Go to Group/Cohort Intervention/treatment Validation group DOC Examination with neurological scales. Behavioral: Examination with neurological scales. Coma Recovery Scale, Glasgo Coma Scale, FOUR scale

2017 Clinical Trials

13. Twenty-four-hour blood pressure variability plays a detrimental role in the neurological outcome of hemorrhagic stroke Full Text available with Trip Pro

Twenty-four-hour blood pressure variability plays a detrimental role in the neurological outcome of hemorrhagic stroke Background Blood pressure variability (BPV) is a modifiable risk factor for stroke. This study was performed to determine the prognostic role of BPV in patients with acute hemorrhagic stroke. Methods The data of 131 hospitalized hypertensive patients with spontaneous intracerebral hemorrhage (sICH) were collected. All patients underwent examinations using several neurological (...) scales (Glasgow Coma Scale, National Institutes of Health Stroke Scale, and modified Rankin scale [mRS]) and BP measurements at different time points. Results Sex, age, hematoma volume, and neurological scores were not significantly different between patients with a favorable and unfavorable prognosis for sICH. However, significant differences were found in hypertension, diabetes, metabolic syndrome, atrial fibrillation, smoking, and stroke history. The standard deviation (SD), coefficient

2018 The Journal of international medical research

14. Combination of initial neurologic examination and continuous EEG to predict survival after cardiac arrest. (Abstract)

was evaluated using the Full Outline of UnResponsiveness (FOUR) score and organ system dysfunction determined using the SOFA score. We defined four categories of initial post-cardiac arrest illness severity (PCAC): (I) awake, (II) coma (not following commands but intact brainstem responses) + mild cardiopulmonary dysfunction (SOFA cardiac + respiratory score < 4), (III) coma + moderate-severe cardiopulmonary dysfunction (SOFA cardiac + respiratory score ≥ 4), and (IV) coma without brainstem reflexes (...) Combination of initial neurologic examination and continuous EEG to predict survival after cardiac arrest. Prognosticating outcome following cardiac arrest requires a multimodal approach. We tested whether the combination of initial neurologic examination combined with continuous EEG was superior to either test alone for predicting survival after cardiac arrest.Review of consecutive patients receiving continuous EEG monitoring between April 2010 and June 2013. Initial neurologic examination

2015 Resuscitation

15. 30-Day In-hospital Trauma Mortality in Four Urban University Hospitals Using an Indian Trauma Registry. (Abstract)

vital signs, and health service performance indicators (time of injury to admission, investigation, or intervention) on all patients with traumatic injuries admitted to four public university hospitals in three Indian megacities.Of the 11,202 hospitalized trauma patients, 21.4 % died within 30 days of hospitalization. The median age was 30 years for survivors and 37 years for non-survivors. The on-admission systolic blood pressure and Glasgow Coma Score was near-normal in survivors (...) , but was significantly lower in non-survivors and associated with both early and late mortality (p = 0.001). In the absence of a trauma system, there were process-of-care delays from injury to reaching and being examined, investigated, or operated in the hospital.Using a multi-institutional Indian registry, this study is the first to systematically document that the 30-day in-hospital trauma mortality was twice that found in similar registries from high-income countries. Physiological scoring of on-admission vitals

2016 World Journal of Surgery

16. Longitudinal Study of the Default-mode Network Connectivity in Brain Injured Patients Recovering From Coma

. The investigators hypothesized that DMN connectivity strength would be related to the level of consciousness of brain-damaged patients. The investigators will follow severely brain-injured patient in coma. Clinical examination using standardized behavioural scales: FOUR score (Full Outline of UnResponsivess), Coma Recovery Scale-Revised); and brain imaging assessesments using MRI (functional and anatomical connectivity, cortical thickness) will be performed at: 3 to 30 (visit 1), and 60 (visit 2) days after (...) brain-damaged patients, as assessed by standardized behavioural scales (FOUR score, CRS-R). Furthermore, we expected that a disruption of functional connectivity in the DMN could predict brain-damaged patient's recovery. Secondary Outcome Measures : Compare functional and structural DMN connectivity between 1 and 2 month after severe brain injury [ Time Frame: VISIT1 = coma state (an expected average of 3 to 30 days after brain injury), VISIT2 = recovery phase (an expected average of 30 to 60 days

2012 Clinical Trials

17. Criteria of Extubation Success of Brain Injured Patients. Elaboration of a Prognostic Score

] Localisation of brain injury (hemispheric, supra- or sub-tentorial) at patient admission in ICU [ Time Frame: at day 1 ] Complete neurological examination (Glasgow score, Coma Recovery Scale, FOUR score, cough, brain stem reflexes) just before extubation [ Time Frame: at day 1 ] cardiologic history (cardiac insufficiency or ischemic cardiomyopathy) during ICU stay [ Time Frame: at day 1 ] - Pulmonary examination (arterial gasometry, ventilatory parameters: mode, frequency, positive end expiratory pressure (...) , Clermont-Ferrand: Critical Care Brain injured patients Mechanical Ventilation Weaning Extubation Prognostic score Clinical examination Additional relevant MeSH terms: Layout table for MeSH terms Brain Injuries Brain Diseases Central Nervous System Diseases Nervous System Diseases Craniocerebral Trauma Trauma, Nervous System Wounds and Injuries

2014 Clinical Trials

18. The Presence of Nonthoracic Distracting Injuries Does Not Affect the Initial Clinical Examination of the Cervical Spine in Evaluable Blunt Trauma Patients: A Prospective Observational Study. (Abstract)

of the c-spine.This is a prospective observational study conducted at a Level I Trauma Center from January 1, 2008, to December 31, 2009. After institutional review board approval, all evaluable (Glasgow Coma Scale score ≥13) blunt trauma patients older than 16 years sustaining a c-spine injury were enrolled. A distracting injury was defined as any immediately evident bony or soft tissue injury or a complaint of non-c-spine pain whether or not an actual injury was subsequently diagnosed. Information (...) regarding the initial clinical examination and the presence of a distracting injury was collected from the senior resident or attending trauma surgeon involved in the initial management.During the study period, 101 evaluable patients sustained a c-spine injury. Distracting injuries were present in 88 patients (87.1%). The most common was rib fracture (21.6%), followed by lower extremity fracture (20.5%) and upper extremity fracture (12.5%). Only four (4.0%) patients had no pain or tenderness

2011 Journal of Trauma

19. Coma Full Text available with Trip Pro

causes, or can be . Clinically, a coma can be defined as the inability to consistently follow a one-step command. It can also be defined as a score of ≤ 8 on the (GCS) lasting ≥ 6 hours. For a patient to maintain consciousness, the components of wakefulness and awareness must be maintained. describes the quantitative degree of , whereas relates to the qualitative aspects of the functions mediated by the cortex, including cognitive abilities such as attention, sensory perception, explicit memory (...) of fever (Sydenham, 1685). Signs and Symptoms [ ] Image of a man in a coma. Image of the man still unresponsive to stimuli. General symptoms of a person in a comatose state are: Inability to voluntarily open the eyes A non-existent sleep-wake cycle Lack of response to physical (painful) or verbal stimuli Depressed brainstem reflexes, such as pupils not responding to light Irregular breathing Scores between 3 and 8 on the Causes of Coma [ ] Many types of problems can cause coma. Some examples

2012 Wikipedia

20. Clinical care of severe acute respiratory infections – Tool kit

monitoring 51 4.4 National Early Warning Score (NEWS) for adults 52 4.5 Paediatric Early Warning Score (PEWS) 54 5. RESPIRATORY SPECIMEN COLLECTION AND PROCESSING 55 Summary 56 References and resources 57 5.1 Differential diagnosis of SARI 58 5.2 Specimen collection kit for upper respiratory tract specimens 59 5.3 Nasopharyngeal swab technique 60 5.4 Posterior pharyngeal swab or throat swab technique 61 5.5 Tracheal aspirate technique 62 5.6 Guideline for specimen storage 63 5.7 Material for specimen (...) References and resources 115 10.1 Numerical pain assessment scales 117 10.2 Behavioural pain assessment scales 118 10.3 COMFORT-B Scale to assess sedation in children 122 10.4 Richmond Agitation-Sedation Scale (RASS) 125 10.5 Flowchart and worksheet for the Confusion Assessment Method of the ICU for adults (CAM-ICU) 126 10.6 Flowchart and worksheet for the Confusion Assessment Method of the ICU for children (pCAM-ICU) 128 10.7 Procedure for assessing attention: attention screening exam (ASE) for adults

2020 WHO Coronavirus disease (COVID-19) Pandemic

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