OBJECTIVE The Glasgow Coma Scale (GCS) is widely used to objectively describe the extent of patients' impaired consciousness. However, there are known variations in scoring GCS both in adults and children which may impact patient management. The aim of this audit is to assess the application of GCS by medical and nursing staff in pediatric medical patients. SUBJECT AND METHODS An online questionnaire was distributed amongst doctors and nurses working in the Department of Child and Adolescent Health at Mater Dei Hospital in Malta. The participants assigned GCS for 8 case scenarios involving children of different ages with varying levels of consciousness. Results were analyzed by calculating percentage agreement and by Cronbach's alpha. RESULTS 66 participants were studied, with a response rate of 52%. Performance was poor overall, with Cronbach alpha 0.53. Correlation was better at the upper and lower ends of the scale and the worst performance was for verbal response. Only respondents with 5 - 10 years of experience achieved acceptable consistency in the application of the GCS (Cronbach alpha 0.78). CONCLUSION There is considerable variation in application of GCS in pediatric patients, highlighting the need for education and training to improve consistency for this commonly used neurological assessment tool.

中文翻译：

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格拉斯哥昏迷量表在儿科患者中的应用不一致。

目的 格拉斯哥昏迷量表（GCS）广泛用于客观描述患者意识受损的程度。然而，成人和儿童的 GCS 评分存在已知差异，这可能会影响患者管理。本次审核的目的是评估医务人员和护理人员在儿科患者中应用 GCS 的情况。主题和方法 在马耳他 Mater Dei 医院儿童和青少年健康科工作的医生和护士中分发了一份在线调查问卷。参与者为 8 个案例场景分配了 GCS，涉及不同年龄、不同意识水平的儿童。通过计算一致性百分比和 Cronbach's alpha 来分析结果。结果 对 66 名参与者进行了研究，响应率为 52%。总体表现较差，Cronbach alpha 为 0.53。量表上下两端的相关性较好，而口头反应的表现最差。只有具有 5 - 10 年经验的受访者才能在 GCS 应用中达到可接受的一致性（Cronbach alpha 0.78）。结论 GCS 在儿科患者中的应用存在相当大的差异，强调需要进行教育和培训，以提高这种常用神经系统评估工具的一致性。