RESUMO
Background: Pain assessment in ICU patients turns out to be a daily challenge for the attending teams, particularly in those patients who are intubated endotracheally; on mechanical ventilation or analgosedated as such patients are unable to self-assess existence and intensity of pain. Guidelines to identify pain in these patients are crucial for physicians for effective management
Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1994, through March 2017. The following search terms were used: pain management in ICU, pain in ICU, pain assessment by behavior, pain assessment in intubated patients
Aim: Our aim in this study was to understand how to assess and manage pain in an intensive care unit patient, particularly those patients who are unable to self-report or assess
Conclusion: Physical clues given by comatose or intubated patients in critical care unit must be used as a method to identify existence of pain, and must be managed effectively to decrease discomfort and prevent short and long term adverse effects
RESUMO
Evaluation of level of consciousness has become essential for anticipation of sepsis and septic shock. Both the Sequential Organ Failure Assessment [SOFA] score and the quick SOFA score utilize the Glasgow Coma Score [GCS] for screening of sepsis
Objectives: the aim of this review is to determine and study the role of Glasgow coma score in anticipation of sepsis and septic shock
Methods: To achieve this aim, we have searched online database, namely PubMed and Cochrane Library for studies and review articles assessing the significance of assessment of Glasgow Coma Scale [GCS] for anticipating sepsis or septic shock. Thirteen appropriatelyrelated studies were selected for review
Results: Disturbed sensorium was found to be a sensitive early indicator for sepsis, thus GCS is used for assessment of both the Sequential Organ Failure Assessment SOFA and quick SOFA scores qSOFA scores. Lower GCS scores were associated with high mortality rates
Discussion: Encephalopathy is an early sign of sepsis and septic shock. Glasgow Coma score GCS was a good indicator of neurological dysfunction evaluated by the SOFA and qSOFA scores. The use of GCS was also a predictor of mortality in patients with sepsis. Some researchers, however, reported that GCS was not the best tool for measuring brain dysfunction in sepsis
Conclusions: Glasgow coma score can anticipate sepsis and septic shock, and predict the outcome of sepsis