Sedation Scale of Hughes et al for Children in the Intensive Care Unit

Description

Hughes et al developed a scale for evaluating sedation in children receiving care in the Intensive Care Unit (ICU). This can be used to assess reversal of sedation with return to full alertness. The authors are from Alder Hey Children's Hospital in Liverpool, England.

NOTE: This appears to be a modification of the Modified Glasgow Coma Score (above).

Scored parameters:

(1) eye opening

(2) verbal response

(3) motor response to stimuli

(4) level of consciousness

Observed parameters:

(5) pattern of breathing

(6) respiration

(7) respiratory rate

(8) cough in response to suction

Parameter	Finding	Points
eye opening	none	1
	to pain	2
	to speech	3
	spontaneous	4
verbal response	none in child	1
	incomprehensible in child	2
	inappropriate in child	3
	confused in child	4
	orientated in child	5
	none in infant	1
	cry in infant	2
	alert and appropriate in infant	3
motor response to stimulus	none in child	1
	abnormal extension in child	2
	abnormal flexion in child	3
	withdrawal from pain in child	4
	localization of pain in child	5
	obeys commands in child	6
	none in infant	1
	abnormal extension in infant	2
	abnormal flexion in infant	3
	withdrawal from pain in infant	4
level of consciousness	unconscious	1
	semi-conscious	2
	sleepy but rousable	3
	fully awake	4

sedation score =

= SUM(points for all 4 parameters)

Parameter	Finding
pattern of breathing	regular
	irregular
respirations	normal
	shallow
respiratory rate	in breaths per minute
cough in response to suction	present
	absent

Interpretation:

• minimum score: 4

• maximum score: 19 for children and 15 for infants

• The higher the score, the greater the level of consciousness.

Criteria for being considered fully conscious:

(1) score >= 17 in child or >= 13 in an infant

(2) regular respiratory pattern

(3) normal respirations

(4) respiratory rate >= 20 breaths per minute

(5) presence of cough in response to suction

To read more or access our algorithms and calculators, please log in or register.

Description

Specialty

ICD-10