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ObjectiveTo compare current care with a proposed gold standard (formal coma scale use) for assessment of children presenting with altered consciousness.DesignA prospective study.SettingKenyatta National Hospital, Nairobi, Kenya.SubjectsOne hundred and seventy children consecutively admitted to the hospital.Main outcome measuresProportion of children assessed using a formal coma scale (gold standard) while presenting with altered consciousness.ResultsFindings revealed that only 8% of children were assessed using the formal coma scale at admission. The level of neurological deficit was described using general and potentially misleading descriptive terms rather than formal coma scales.ConclusionThe use of a formal coma scale and relevant simple investigations were seldom used. The quality of care of children admitted to the hospital with altered consciousness standard would benefit from defining and implementing management guidelines (protocols).


Journal article


East African medical journal

Publication Date





589 - 592


Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.


Humans, Consciousness Disorders, Glasgow Coma Scale, Prospective Studies, Child, Preschool, Infant, Kenya, Female, Male