Certified Pediatric Emergency Nurse (CPEN) Practice Exam

When is intubation indicated according to the established guidelines?

1. With a Glasgow Coma Score of less than 10

2. With a Glasgow Coma Score of less than 8

3. With a Glasgow Coma Score above 12

4. Only during surgical procedures

The correct answer is: With a Glasgow Coma Score of less than 8

Intubation is indicated when the Glasgow Coma Score (GCS) is less than 8, as this level reflects a significant impairment of consciousness and potential compromise of the airway. A GCS below 8 suggests that a patient may not be able to protect their airway due to decreased responsiveness, which increases the risk of airway obstruction or aspiration. This threshold is widely recognized in clinical practice as a criterion that indicates the need for airway intervention to ensure adequate ventilation and oxygenation in critically ill patients. A GCS of less than 10 also indicates a level of impairment, but the more critical threshold for intubation is set at a GCS of less than 8. This makes the second option the most appropriate choice. A GCS above 12 suggests a patient is relatively alert and able to maintain their airway, making intubation unnecessary in those cases. Additionally, while intubation can occur during surgical procedures, it is not exclusive to that context, further reaffirming the importance of the GCS score in determining the need for airway management.