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EVALUATION OF ASSESSMENT INSTRUMENTS USED ON CHILDREN PRESENTING WITH ALTERED LEVEL OF CONSCIOUSNESS
Abstract
Objective: To compare current care with a proposed gold standard (formal coma scale use) for assessment of children presenting with altered consciousness.
Design: A prospective case record review (n = 170).
Setting: Kenyatta National Hospital, Nairobi, Kenya.
Subjects: One hundred and seventy children consecutively admitted to the Hospital.
Main outcome measures: Proportion of children assessed using a formal coma scale (gold standard) while presenting with altered consciousness.
Results: Findings revealed that only eight percent of children were assessed using the formal coma scale at admission. The level of neurological defi cit was described using general and potentially misleading descriptive terms rather than formal coma scales.
Conclusion: The use of a formal coma scale and relevant simple investigations were seldom used. The quality of care of children admitted to the hospital with altered consciousness standard would benefi t from defi ning and implementing management guidelines (protocols).
Design: A prospective case record review (n = 170).
Setting: Kenyatta National Hospital, Nairobi, Kenya.
Subjects: One hundred and seventy children consecutively admitted to the Hospital.
Main outcome measures: Proportion of children assessed using a formal coma scale (gold standard) while presenting with altered consciousness.
Results: Findings revealed that only eight percent of children were assessed using the formal coma scale at admission. The level of neurological defi cit was described using general and potentially misleading descriptive terms rather than formal coma scales.
Conclusion: The use of a formal coma scale and relevant simple investigations were seldom used. The quality of care of children admitted to the hospital with altered consciousness standard would benefi t from defi ning and implementing management guidelines (protocols).
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