Glasgow Coma Scale
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Objective
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The Glasgow Coma Scale (GCS) was first created by Graham Teasdale and Bryan Jennett in 1974. It is a clinical scale to assess a patient’s “depth and duration of impaired consciousness and coma”[1] following an acute brain injury. Healthcare practitioners can monitor the motor responsiveness, verbal performance, and eye opening of the patient in the form of a simple chart. The GCS is the most commonly used tool internationally for this assessment and has been translated into 30 languages. It should not, however, be confused with the Glasgow Outcome Scale (GOS), which evaluates persistent disability after brain damage. [2]
Intended Population
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Method of Use[edit | edit source]
Reference
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Evidence[edit | edit source]
Reliability[edit | edit source]
The inter-rater reliabilty of the total Glasgow Coma Scale is p=0.86. Some research has subdivided the inter-rater reliabiltiy for each subscale. For the eye score the inter-rater reliability is p=0.76, the verbal score is p=0.67, and the motor score is p=0.81 [4] The research for test-retest reliability is not recent and should be updated, however the best available evidence is k=0.66-0.77 [5]
Validity[edit | edit source]
The validity of the glascow coma scale comes under fire because a lot of hospitals administer the test while patients have been sedated, often underestimating patient scores. It’s also difficult to elicit accurate scores when patients are intubated.[6] Recent research has refuted that intubation elicits significantly different survival rates with the verbal score of r=0.90 and the total score r=0.97[7]
Responsiveness[edit | edit source]
Miscellaneous
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Links[edit | edit source]
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. The Lancet. 1974 Jul 13;304(7872):81-4.
- ↑ Frej M, Frej J. The Glasgow Structured Approach to Assessment of the Glasgow Coma Scale [Internet]. What is GCS - Glasgow Coma Scale. Sir Graham Teasdale; [cited 2017May7]. Available from: http://www.glasgowcomascale.org/what-is-gcs/
- ↑ GCS at 40. Glasgow Coma Scale at 40 | The new approach to Glasgow Coma Scale assessment. Available from: https://www.youtube.com/watch?v=v6qpEQxJQO4 [last accessed 05/07/17
- ↑ Gill M, Reiley D, Green S. Interrater reliability of Glasgow Coma Scale scores in the emergency department. Annals of Emergency Medicine. 2004;43(2):215-223.
- ↑ Brott T, Adams H, Olinger C, Marler J, Barsan W, Biller J et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864-870.
- ↑ Marion D, Carlier P. PROBLEMS WITH INITIAL GLASGOW COMA SCALE ASSESSMENT CAUSED BY PREHOSPITAL TREATMENT OF PATIENTS WITH HEAD INJURIES. The Journal of Trauma: Injury, Infection, and Critical Care. 1994;36(1):89-95.
- ↑ Meredith W, Rutledge R, Fakhry S, Emery S, Kromhout-Schiro S. The Conundrum of the Glasgow Coma Scale in Intubated Patients. The Journal of Trauma: Injury, Infection, and Critical Care. 1998;44(5):839-845.
