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Early tests for brain injury – the Glasgow Coma Scale explained

Solicitors in London

News article published on: 24th June 2014

The Glasgow Coma Scale (GCS) is a basic scoring system used primarily by paramedics who attend the scene of an accident, and in triage by A&E staff when an injured person is admitted to hospital.

The score is often used for an early assessment that there may be a brain injury, and where a more subtle injury is suspected the scores within the ambulance and hospital records are one of the first things your solicitor will assess.

The main benefit of the GCS system is its simplicity. People with even a basic level of training can perform and interpret the test, bearing in mind in the majority of case it can take two years or more and hours of detailed examination to fully diagnose a brain injury.

A top score of 15/15 means the patient is conscious, orientated and responds well to questions, and the lowest score of 3/15 means they are either dead or in a coma. As a rule of thumb, anyone admitted to hospital still showing a score below 15 and with a history of having hit their head ought to be scanned to determine whether there is any organic injury to the brain such as bleeding.

The scale consists of three tests: eye, verbal and motor responses:

Eye Response – There are four levels:

No eye opening.
Eye opening in response to pain.
Eye opening to speech.
Eyes opening spontaneously.

Verbal Response – There are five levels:

No verbal response.
Incomprehensible sounds.
Inappropriate words.
Motor Responses – There are six levels:

No motor response.
Extension to pain. (Eg: extension of wrist)
Abnormal flexion to pain. (Eg: flexion of wrist)
Flexion/Withdrawal to pain. (Eg: pulls body part away when nail-bed pinched)
Localizes to pain. (Eg: purposeful movements towards painful stimuli)
Obeys commands.

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