Intoxication Score in Short Acting Barbiturate Overdosage

Patients who have overdosed on short acting barbiturates can be quickly evaluated using a state-of-intoxication score developed in 1982.

Components:

(1) modified Glasgow coma score with 3 parameters

(2) vital signs score with 3 parameters

Modified Glasgow Coma Score

Parameter	Finding	Points
eye opening	open	5
	spontaneous open	4
	to speech	3
	to pain	2
	none	1
best verbal response	conversant, clear speech	6
	oriented, but speech slow or slurred	5
	confused, with screaming or shouting	4
	inappropriate words	3
	incomprehensible words	2
	none	1
best motor response	ambulatory	7
	obeys commands, spontaneous movements	6
	localizing to pain	5
	flexing withdrawal	4
	abnormal flexing, decorticate	3
	extending, decerebrate	2
	none	1

Vital Signs Score

Parameter	Finding	Points
respirations per minute	>= 40	6
	30 - 39	5
	12 - 29	4
	< 12	3
	shallow spontaneous	3
	Cheyne Stokes breathing	2
	Biot breathing	2
	apnea	1
mean arterial blood pressure	>= 147 mm Hg	6
	109 - 146	5
	80 - 108	4
	60 - 79	3
	40 - 59	2
	< 40	1
temperature	>= 40°C	7
	38.9 - 39.9°C	6
	37.8 - 38.8°C	5
	36.7 - 37.7°C	4
	35.6 - 36.6°C	3
	34.5 - 35.5°C	2
	<= 34.4 °C	1

where:

• mean blood pressure in mm Hg = ((2 * (diastolic blood pressure)) + (systolic blood pressure) / 3

modified Glasgow coma score =

= (points for eye opening) + (points for best verbal response) + (points for best motor response)

score for vital signs =

= (points for respirations) + (points for mean arterial blood pressure) + (points for body temperature)

intoxication score =

= (modified Glasgow coma score) + (score for vital signs)

Interpretation:

• minimum intoxication score: 6

• maximum intoxication score: 36

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