The Glasgow Coma Scale (GCS) is 40 years old this year and has been widely used to make an initial assessment of the level of consciousness of patients with acute brain injury. GCS is measured on a scale of 3 to 15, with a score of 3 being the most serious and a score of 15 for a normal level of consciousness. Scores are made according to three areas of assessment:
It should be noted that each criterion stipulates that there must be no interfering factor because a patient may not always be capable of assessment for a reason totally unconnected with brain injury and so any interfering factor affecting responses would, in these circumstances, give a misleading score.
Although GCS is a useful tool and medical practitioners and lawyers look out for GCS scores in ambulance and A&E records when making their own assessments later on in claim, there are limitations. Because GCS requires observation of a verbal score, GCS is often not available in ICU and so cannot be used. Also, GCS is said to be insensitive to more subtle derangements of consciousness such as delirium. Critics say the relationship between outcome and GCS is not always linear, meaning a score of 14 or 15 can often underlie a much more serious brain injury. Where there are infering factors, GCS cannot be assessed and, in most serious cases where a patient is paralysed, GCS cannot be used.
The Penningtons Manches personal injury team has a number of specialists in acquired brain injury claims who work with clients who have suffered serious head injuries or debilitating conditons, obtaining funding and making provision for their therapy, long term care and financial needs.