zabmedvestnikЗабайкальский медицинский вестникTransbaikalian Medical Bulletin1998-6173Читинская государственная медицинская академия10.52485/19986173_2024_2_73zabmedvestnik-35Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSОЦЕНКА УРОВНЯ СОЗНАНИЯ В РЕАЛЬНОЙ КЛИНИЧЕСКОЙ ПРАКТИКЕ С ПОМОЩЬЮ ШКАЛЫ КОМЫ ГЛАЗГО И ШКАЛЫ FULL OUTLINE OF UNRESPONSIVENESSASSESSMENT OF THE LEVEL OF CONSCIOUSNESS IN REAL CLINICAL PRACTICE USING THE GLASGOW COMA SCALE AND THE FOUR SCALEВечоркоВ. И.VechorkoV. I.

117513, г. Москва, ул. Островитянова, дом 1, стр. 6; 

111539, г. Москва, ул. Вешняковская, д. 23

1 Ostrovityanova str., bld. 6, Moscow, 117513;

23 Veshnyakovskaya str. Moscow, 111539

ЗиминА. А.ZiminA. A.

117513, г. Москва, ул. Островитянова, дом 1, стр. 6;

111539, г. Москва, ул. Вешняковская, д. 23; 

125367, г. Москва, Волоколамское шоссе, д. 80

1 Ostrovityanova str., bld. 6, Moscow, 117513;

23 Veshnyakovskaya str. Moscow, 111539; 

Volokolamskoe highway, 80, Moscow, 125367

ОбуховаЕ. В.ObuhovaE. V.

117513, г. Москва, ул. Островитянова, дом 1, стр. 6; 

111539, г. Москва, ул. Вешняковская, д. 23

1 Ostrovityanova str., bld. 6, Moscow, 117513;

23 Veshnyakovskaya str. Moscow, 111539

ФГБОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава России; ГБУЗ города Москвы «Городская клиническая больница № 15 имени О.М. Филатова Департамента здравоохранения города Москвы»РоссияPirogov Russian National Research Medical University; City Clinical Hospital No. 15 named after O.M. FilatovRussian FederationФГБОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава России; ГБУЗ города Москвы «Городская клиническая больница № 15 имени О.М. Филатова Департамента здравоохранения города Москвы»; ФГБНУ «Научный центр неврологии» Министерства науки и высшего образования Российской ФедерацииРоссияPirogov Russian National Research Medical University; City Clinical Hospital No. 15 named after O.M. Filatov; Research Center of NeurologyRussian Federation202424072024027379Copyright © Вечорко В.И., Зимин А.А., Обухова Е.В., 20242024Вечорко В.И., Зимин А.А., Обухова Е.В.Vechorko V.I., Zimin A.A., Obuhova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.zabmedvestnik.ru/jour/article/view/35

Исследование уровня сознания является одним из базовых элементов оценки пациентов в жизнеугрожающем состоянии. В зависимости от уровня угнетения сознания определяется тяжесть состояния пациента, планируется маршрутизация больного, а также проводится динамическая оценка на догоспитальном этапе, а также в отделениях реанимации и интенсивной терапии.

Изучены отечественные и зарубежные источники литературы для определения оптимального инструмента и алгоритма его применения при оцeнке уровня сознания пациентов, доставляемых скорой медицинской помощью.

Проведен анализ работ из научных баз PubMed, eLibrary, Google Scholar, MedRxiv, посвященных диагностики, лечению пациентов со сниженным уровнем сознания.

Шкалы Full Outline of UnResponsiveness (FOUR) и шкала комы Глазго (ШКГ) имеют одинаково высокий уровень психометрических параметров при оценке пациентов общего реанимационного профиля, однако оценка стволовых рефлексов, включенная в шкалу FOUR, делает ее оптимальной при сортировке и динамическом наблюдении за пациентами во время проводимого лечения.

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.

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The authors declare that there are no conflicts of interest present.