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The Glasgow Coma Scale: History and current practice

Institute of Neurological Sciences, Glasgow, Scotland, bryan.jennett{at}ntlworld.com

The Glasgow Coma Scale (GCS) was devised to assess injury severity in a multi-centre study of outcome after severe brain damage. It uses unambiguous terms that are readily understood by a wide range of observers. Giving numbers to responses makes communication and display of responsiveness easy and the overall score allows classifi cation of overall severity of brain injury for triage and for epidemiological studies. The total score involves some loss of predictive information. Outcome correlates well with the early GCS both in head injuries and other intensive care patients. When early sedation and ventilation after head injury makes GCS assessment difficult, the motor score is often available and is a useful index of injury severity. The GCS also facilitates monitoring in the early stages after injury, allowing rapid detection of complications. Even among mild injuries (GCS 13- 15) the scale can discriminate between those more or less likely to have detectable brain damage and to be at risk of complications.

Key Words: coma • head injury • severity of brain dysfunction • predicting outcome • monitoring for complications • CT scan

Trauma, Vol. 4, No. 2, 91-103 (2002)
DOI: 10.1191/1460408602ta233oa


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