Glasgow Coma Scale

A person who has sustained a brain injury and has sought emergency medical care is usually assigned a number on the Glasgow Coma Scale. What is the Glasgow Coma Scale, and what does this number mean?

Essentially, the Glasgow Coma Scale is a neurological scale designed to assess the patient’s level of consciousness after brain injury. The scale evaluates the patient’s best eye response, best verbal response, and best motor response, and then assigns a score that ranges from 3 to 15. A score will usually be given by the emergency response team and emergency room physicians, as well as throughout the patient’s hospital stay during the acute care phase. The lower the score is, the more severe the brain injury. Scores below 8 indicate a severe brain injury, scores between 9 and 12 indicate a moderate brain injury, and scores above 13 indicate a minor brain injury.

Pediatric Glasgow Coma Scale

The Glasgow Coma Scale is used to assess young children as well as adults, but is modified to make it more appropriate. In particular, the Pediatric Glasgow Coma Scale takes into consideration the inability of very young children to communicate and obey commands. The Pediatric Glasgow Coma Scale is scored the same way as the adult version, with scores below 8 indicating a severe injury.

The Glasgow Coma Scale and Long-Term Prognosis

Many people want to know if the Glasgow Coma Scale has any long-term meaning. They have questions like, “Does the score indicate future prognosis?” and “Can I tell what kinds of disabilities my loved ones will have based on the score?”

Simply put, the eye, verbal, and motor responses of a brain injury survivor 24 hours after the accident can indicate—to some degree—the eventual outcome. For example, a person with a best score of 3 to 4 24 hours following the accident is likely to die or remain in a vegetative state. Those with scores in the 11 to 15 range, on the other hand, have a high likelihood—close to 90 percent—of making an almost full or full recovery.

However, it’s extremely important to stress that the Glasgow Coma Scale is not an exact science. While statistically those with higher scores tend to have better outcomes, brain injuries are as individual as people themselves. Some people with very low scores have gone on to make almost complete recoveries, while those with high scores have suffered from lifelong disabilities. So while the scale can serve as a guide, it’s impossible to base a long-term prognosis solely on this scale. Nor is it possible to determine the types of disability the survivor will face based on the scale. When it comes to definitely determining the long-term prognosis of a brain injury, the best indicator is time.

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