Journal
JOVE-JOURNAL OF VISUALIZED EXPERIMENTS
Volume -, Issue 168, Pages -Publisher
JOURNAL OF VISUALIZED EXPERIMENTS
DOI: 10.3791/61968
Keywords
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Funding
- University Hospital of Liege
- French Speaking Community Concerted Research Action [ARC 12-17/01]
- Belgian National Funds for Scientific Research (F.R.S-FNRS)
- King Baudouin Foundation
- Marie Sklodowska-Curie Actions [H2020-MSCA-IF-2016ADOC-752686]
- European Union [945539]
- James McDonnell Foundation
- Mind Science Foundation
- Belgian Government (Belgian Science Policy) [P7/06]
- European Commission
- Public Utility Foundation 'Universite Europeenne du Travail'
- Fondazione Europea di Ricerca Biomedica
- BIAL Foundation
- AstraZeneca Foundation
- Belgian National Plan Cancer [139]
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The SECONDs scale is a quick and effective tool for assessing the level of consciousness in patients with severe brain injury. It provides accurate diagnosis through simple items, making it crucial for assessment and treatment decisions in clinical settings.
Establishing an accurate diagnosis is crucial for patients with disorders of consciousness (DoC) following a severe brain injury. The Coma Recovery Scale-Revised (CRS-R) is the recommended behavioral scale for assessing the level of consciousness among these patients, but its long duration of administration is a major hurdle in clinical settings. The Simplified Evaluation of CONsciousness Disorders (SECONDs) is a shorter scale that was developed to tackle this issue. It consists of six mandatory items, observation, command-following, visual pursuit, visual fixation, oriented behaviors, and arousal, and two conditional items, communication and localization to pain. The score ranges between 0 and 8 and corresponds to a specific diagnosis (i.e., coma, unresponsive wakefulness syndrome, minimally conscious state minus/plus, or emergence from the minimally conscious state). A first validation study on patients with prolonged DoC showed high concurrent validity and intra-and inter-rater reliability. The SECONDs requires less training than the CRS-R and its administration lasts about 7 minutes (interquartile range: 5-9 minutes). An additional index score allows the more precise tracking of a patient's behavioral fluctuation or evolution over time. The SECONDs is therefore a fast and valid tool for assessing the level of consciousness in patients with severe brain injury. It can easily be used by healthcare staff and implemented in time-constrained clinical settings, such as intensive care units, to help decrease misdiagnosis rates and to optimize treatment decisions. These administration guidelines provide detailed instructions for administering the SECONDs in a standardized and reproducible manner, which is an essential requirement for achieving a reliable diagnosis.
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