ASSESSMENT OF THE LEVEL OF CONSCIOUSNESS IN REAL CLINICAL PRACTICE USING THE GLASGOW COMA SCALE AND THE FOUR SCALE

Abstract

Examination of the level of consciousness is one of the basic elements of assessing patients in a life-threatening condition. Depression of the consciousness influence on the patient’s severity, therapy planning. The dynamic assessment is carried out at the prehospital stage, as well as in intensive care units. Domestic and foreign literature sources were studied to determine the optimal tool and algorithm for its use in assessing the level of consciousness of patients delivered by emergency medical services. The analysis of the works from the scientific databases PubMed, eLibrary, Google Scholar, MedRxiv devoted to the diagnosis and treatment of patients with a reduced level of consciousness was carried out. The Full Outline of Unresponsiveness (FOUR) scale and the Glasgow Coma Scale (GCS) have an equally high level of psychometric parameters when assessing patients in general intensive care, however, the assessment of brainstem reflexes included in the FOUR scale makes it optimal for triage and dynamic monitoring of patients during ongoing treatment.