Monday, April 26, 2021

REBEL EM - April 26, 2021 - By Jorge Aceves
“Clinical Bottom Line
In summary, the evidence for using a patient’s GCS score is mixed. Recent review articles have highlighted the paucity of strong evidence behind the classic adage of “GCS less than 8, intubate”.The evaluation of a patient’s GCS can vary significantly between providers. While multiple retrospective studies have shown an association between a depressed level of consciousness and aspiration, several prospective studies have contradicted this and appear to show a significantly lower risk of aspiration in these patients. Furthermore, the presence or absence of airway reflexes should not be assumed based on a patient’s GCS. The Glasgow coma scale can be utilized as one factor to help dictate airway management, but rigid use of a cut-off is not currently supported by robust evidence. In light of this, emergency physicians should use their gestalt and individually assess each patients’ likelihood of airway compromise”