RT Journal Article
SR Electronic
T1 Development of a modified paediatric coma scale in intensive care clinical practice
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 519
OP 521
DO 10.1136/adc.77.6.519
VO 77
IS 6
A1 A Tatman
A1 A Warren
A1 A Williams
A1 J E Powell
A1 W Whitehouse
YR 1997
UL http://adc.bmj.com/content/77/6/519.abstract
AB James’ adaptation of the Glasgow coma scale (JGCS) was designed for young children. Intubated patients are not allocated a verbal score, however, so important changes in a patient’s conscious level may be missed. A grimace score was therefore developed and assessed for use in intubated children.  Two observers made a JGCS observation within 15 minutes of each other. One observer was the patient’s nurse and the other a trained investigator. Interobserver reliability was determined between the first and second observation for each component of the scale. Reliability was measured using κ and weighted κ statistics.  Seventy three children had 104 sets of observations. Interobserver reliability was moderate to good for all components, with the grimace score better than the verbal score.  It is concluded that the grimace score is more reliable than the verbal score and may be useful in intubated patients in whom the verbal score cannot be used.