Construction of cough reflex intensity score for critically ill patients based on the Delphi method

Yong-kai Li, Yang Liu, Wen-bin Jia, Jian-zhong Yang, Jun Xu

Table 2. The second round of investigation on cough reflex intensity scores

Grade Indicators (if one of them is met) Importance (points) Variation coefficient Cough reflex intensity score of 1 (no cough) a. Conscious and cooperative, but completely incapable of coughing or making coughing noises b. Unconscious state such as coma (GCS score <8) and unable to cough c. No cough reflex under sputum suction tube stimulation, or stimulation by pressing the cricothyroid membrane 4.53±0.57 0.12 Cough reflex intensity score of 2 (with cough, very weak) a. Cough awareness or cough action, and a weak cough sound, sputum not coughed out of the vocal door b. Cough reflex under the sputum suction tube stimulation, and the sputum sucked out by the sputum suction tube 4.20±0.76 0.15 Cough reflex intensity score of 3 (with cough, strong) Strong coughing sounds in the absence of sputum suction tube stimulation, most of the sputum coughed out of the vocal cavity, but not out of the mouth 4.27±0.69 0.18 Cough reflex intensity score of 4 (with cough, very strong) Loud cough sounds and sputum coughed out of the mouth 4.40±0.68 0.12