How the Giasgow Coma Scale Works? - Lulich Attorneys & Consultants
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How the Giasgow Coma Scale Works?

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Car accidents often cause violent collisions. Drivers and passengers often bounce around the car.  They can strike the dashboard, the window, or even each other. In addition to broken bones and spinal cord damage, many car accident victims suffer a traumatic brain injury (TBI). Neurologists and other doctors use the Glasgow coma scale to analyze the severity and scope of this type of devastating injury.

TBI victims often need a lifetime of medical care. They usually need to see a broad array of doctors and therapists. Many  victims lose some cognitive abilities. Victims also often lose some of their physical functions. A proper analysis of a TBI victim’s condition is needed to provide the best medical care possible.

The Glasgow Coma Scale Measurements

The scale assigns scores to 15 medical conditions.  The conditions and scores are as follows:

  • First, the ability to open one’s eyes.
    • Spontaneously – 4
    • To sound – 3
    • To pressure – 2
    • No ability – 1
  • Then, the ability to respond verbally
    • Oriented – 5
    • Confused – 4
    • Can respond to words but isn’t coherent – 3
    • Can respond to sounds but not to words  – 2
    • Can’t respond to any verbal stimuli – 1
  • Finally, motor responses
    • Complies with commands – 6
    • Localized responses – 5
    • Flexes normally to pain -4
    • Flexes but not normally to pain – 3
    • Extension – 2
    • No motor response – 1

Generally, the tester uses the patient’s best response when multiple tests are given.  The responses are kept on a chart. In this way, if there are improvements or the patient’s condition worsens, the scores can be adjusted.

The combined Glasgow Coma Scale score

The three individual tests are totaled. The scores are evaluated as follows:

  • A severe traumatic brain injury. A score between 3 and 8.
  • A moderate traumatic brain injury. A score between 9 and 12
  • A moderate traumatic brain injury. A score between 13 and 15.

Patients with a moderate or severe Glasgow coma score often have impairments that are long-term. The impairments can be physical, emotional, or cognitive. Many times, they are a combination of all three. Patients with a mild score may develop permanent injuries.

The score may have limited relevancy if the patient is in shock, intoxicated, or under the influence of drugs.

Glasgow Children adjustments for children

It is extra hard to evaluate children who have suffered a TBI due to a car accident or any other cause. Children can’t communicate in the same way as parents. Doctors used an adjusted scale, called a Pediatric Glasgow coma Scale, to evaluate children.

The three tests are the same but the scoring is somewhat different:

  • The eye opening test. The 3 point test examines the child’s ability to respond to voice instead of any sound.
  • Then, the the verbal response test. The scoring is as follows:
    • Oriented to smiles, can follow objects, is interactive – 5
    • Cries but can be consoled –
    • Not consolable, inconsistent responses – 3
    • Agitated responses -2
    • No response -1
  • Then, the  motor response test
    • Purposeful response – 6
    • Withdraws from touch – 5
    • Withdraws to pain – 4
    • Abnormal flexion – 3
    • “Decerebrate response” – 2
    • No response – 1

The combined score for children works the same way  as it does for adults.

 

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