Nurses' understanding and experience of applying painful stimuli when assessing components of the Glasgow Coma Scale

Aims and objectives To evaluate nurses' application, understanding and experience of applying painful stimuli when assessing components of the Glasgow Coma Scale. Background The Glasgow Coma Scale has been subjected to much scrutiny and debate since its publication in 1974. However, criticism, confusion and misunderstandings in relation to the use of painful stimuli and its application remain. An absence of evidence‐informed guidance on the use and duration of application of painful stimuli remains, with the potential to negatively impact on decision‐making, delay responsiveness to neurological deterioration and result in adverse incidents. Design and Methods This international study used an online self‐reported survey design to ascertain neuroscience nurses' perceptions and experiences around the application of painful stimuli as part of a GCS assessment (n = 273). The STROBE checklist was used. Results Data revealed varied practices and a sense of confusion from participants. Anatomical sites for the assessment of pain varied, but most respondents identified the trapezius grip/pinch in assessing eye‐opening and motor responses. Most respondents identified they assess eye‐opening and motor responses together and apply pain for