The Critical Care Podcast - Building the right foundation:: Neurological assessments and management of sedation and pain relief medication

Join Raluca (ICU Nurse) and Chris (ICU Consultant) in looking after Mary, a (hypothetical) patient who has been in ICU for a week following a cardiac arrest.

We are looking at reducing sedation and assessing Mary’s neurology. Join us in discussion:

• Sedation? What is this and what medications we may use?
  
• Pain relief: what and why?
  
• How to assess neurology: GCS, RASS and CAM-ICU
  
• Delirium and its management.
  

We mention research around GCS:

• Glasgow Coma Scale:  Teasdale, G. and Jennett, B. (1974) 'Assessment of coma and impaired consciousness’, The Lancet, 2 (7872), pp.81-84.
  
• Green, S.M. (2011) ‘Cheerio, Laddie! Bidding Farewell to the Glasgow Coma Scale’, Annals of Emergency Services, 58(5), pp. 427-430.
  
• Reith FC, Synnot A, van den Brande R, Gruen RL, Maas AI (2017) ‘Factors Influencing the Reliability of the Glasgow Coma Scale: A Systematic Review.’,  Neurosurgery, 1;80(6), pp: 829-839. doi: 10.1093/neuros/nyw178.
  
• Ramazani, J. and Hosseinei, M. (2019) ‘Comparison of Full Outline of Unresponsiveness Score and Glasgow Coma Scale in Medical Intensive Care Unit’, Annals of Cardiac Anaesthesia, 22(2), pp. 143-148,
  
• Wolf, C., Wijdicks, E., Bamlet, W., McLelland, R. (2007) ‘Further validation of the FOUR score coma scale by intensive care nurses’ in Mayo Clinic Proceedings, 82(4) pp.435-438
  

Main debate: how useful do you find these assessment tools? Drop us a message…

Don’t miss our three takeaway messages and please send us yours!

Enjoy the episode!

Raluca Vagner- Intensive Care Nurse @RalucaVagner

Chris Gough- Intensive Care Consultant @GoughC

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