Neuro Obs in ICU

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I am a General ICU nurse with just over six years experience in 
predominately Trauma/neuro intensive care both in Australia and the UK. I am 
after opinion, current practice/guidelines, or relevant references/evidence 
for assessment using the Glasgow Coma Score in order to facilitate best 
practice at my current workplace.

Most specifically,

A) What is the best site for giving central pain stimulus?

B) Is there any true relevance to assessing using peripheral stimulus? Or is 
it impossible distinguish it from purely a spinal reflex?

C) Is it necessary to assess using the GCS (ie give painful stimulus etc, 
hourly/4th hourly etc), to a sedated patient? Or is pupil assessment the 
only guide to deterioration once sedation is commenced?

Any information is greatly appreciated

Brenton

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