Category: Neurology
Keywords: Glasgow Coma Scale, GCS, traumatic brain injury, TBI, survey (PubMed Search)
Posted: 5/13/2015 by WanTsu Wendy Chang, MD
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Are We Using the Glasgow Coma Scale Reliably?
Reported by Responders | |
Patient population in which GCS is used | Traumatic brain injury (96%) Other neurological disorders (78%) |
Intended purpose of GCS | Classification of severity of injury (51%) Serial evaluation of patient over time (33%) Clinical decision making (44%) Prognostication (17%) |
Application of stimulus | Both arms and legs (62%) Only arms (37%) |
Type of stimuli used | Nail bed pressure (57%) Lateral side of finger (22%) Supra-orbital nerve pressure (52%) Trapezius or pectoralis pinch (50%) Sternal rub (53%) Retromandibular stimulation (24%) Earlobe stimulation (16%) |
Reporting of GCS | Description in words, e.g. no eye opening, no motor (19%) Numerical report, e.g. E1V1M1 (46%) Sum score, e.g. EVM=3 (35%) |
Bottom line: There are variations in the application, assessment, and reporting of the GCS. A standardized approach is needed for it to be a reliable assessment and communication tool.
Reith FCM, Brennan PM, Maas AIR, Teasdale GM. Lack of standardization in the use of the Glasgow Coma Scale: Results of international surveys. J Neurotrauma. 2015; May 7. [Epub ahead of print]