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Tue, 26 Feb 2002 06:55:01 -0500

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Charles,

I think Jean is referring specifically to the motor component; I suspect
this mostly because that's precisely what she wrote.  

Further, I believe that her concern relates to the fact that this particular
motor score was '1' (as would be verbal score, and probably, though not
certainly, the eye-opening) not as a result of coma, but rather from
chemical paralysis.  In this case, as in all such cases, there is simply no
accurate means of assessing level of consciousness.  GCS is "N/A."  So is
AVPU, for that matter.  Just another example of inconvenient consequences
arising from perfectly good decisions.

Pret

-----Original Message-----
From: Krin135@aol.com [ mailto:Krin135@aol.com <mailto:Krin135@aol.com> ]
Sent: Tuesday, February 26, 2002 4:13 AM
To: trauma-list@trauma.org
Subject: Re: AVPU trivia

In a message dated 26-Feb-02 02:05:07 Central Standard Time,
Jean.A.Proehl@Hitchcock.ORG writes:

>
>  I couldn't agree more!  After emphasizing correct GCS assessment trauma
> classes for almost 20 years I am still astounded to see experienced
critical
> care and emergency nurses give a motor score of 1 for a patient who is
> chemically paralyzed!  I see this happen at least once a month if not
more.

> Has anyone found a way  to solve this? Remediation with every nurse, every
> time is not always possible........
> 
>  Jean Proehl
>  Emergency Clinical Nurse Specialist

ummmm...I thought that the *minimum* score in each category *was* 1? This
would result in a fully paralyzed patient getting a 3 over all (no
spontaneous eye opening, no speech and no motor movement in response to
painful stimuli)...or did you mean that the *total* score was 1?

ck

Charles S. Krin, DO

--
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Charles, I think Jean is 
referring specifically to the motor component; I suspect this mostly because 
that's precisely what she wrote.&nbsp; 
Further, I believe that her 
concern relates to the fact that this particular motor score was '1' (as would 
be verbal score, and probably, though not certainly, the eye-opening) not as a 
result of coma, but rather from chemical paralysis.&nbsp; In this case, as in 
all such cases, there is simply no accurate means of assessing level of 
consciousness.&nbsp; GCS is "N/A."&nbsp; So is AVPU, for that matter.&nbsp; Just 
another example of inconvenient consequences arising from perfectly good 
decisions. Pret -----Original Message----- From: 
Krin135@aol.com [<A 
href="mailto:Krin135@aol.com">mailto:Krin135@aol.com</A>] Sent: Tuesday, 
February 26, 2002 4:13 AM To: trauma-list@trauma.org Subject: Re: AVPU 
trivia In a message dated 26-Feb-02 02:05:07 Central Standard 
Time, Jean.A.Proehl@Hitchcock.ORG writes: &gt; &gt;&nbsp; I 
couldn't agree more!&nbsp; After emphasizing correct GCS assessment 
trauma &gt; classes for almost 20 years I am still astounded to see 
experienced critical &gt; care and emergency nurses give a motor score of 
1 for a patient who is &gt; chemically paralyzed!&nbsp; I see this happen at 
least once a month if not more. &gt; Has anyone found a way&nbsp; to 
solve this? Remediation with every nurse, every &gt; time is not always 
possible........ &gt;&nbsp; &gt;&nbsp; Jean Proehl &gt;&nbsp; Emergency 
Clinical Nurse Specialist ummmm...I thought that the *minimum* score in 
each category *was* 1? This would result in a fully paralyzed patient getting 
a 3 over all (no spontaneous eye opening, no speech and no motor movement in 
response to painful stimuli)...or did you mean that the *total* score was 
1? ck Charles S. Krin, DO -- trauma-list : 
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