It’s also difficult to elicit accurate scores when patients are intubated. The validity of the Glasgow Coma Scale comes under fire because a lot of hospitals administer the test while patients have been sedated, often underestimating patient scores. īased on a recent systematic review, the total score is typically less reliable than the individual components with a total Kappa value of 77% as compared to the eye, motor, and verbal scores which had Kappa values of 89%, 94%, and 88% respectively. The research for test-retest reliability is not recent and should be updated, however, the best available evidence is k = 0.66 - 0.77.

For the eye score the inter-rater reliability is p = 0.76, the verbal score is p = 0.67, and the motor score is p=0.81. Some research has subdivided the inter-rater reliability for each subscale. The inter-rater reliability of the total Glasgow Coma Scale is p = 0.86. They may exhibit decorate or decerebrate posturing. These patients present as obtunded to comatose, they are unable to follow directions. These patients are typically drowsy or obtunded, they can open eyes and localise painful stimuli upon assessment. These patients are awake, can present with confusion but are able to follow directions and communicate. The GCS Assessment Aid has four steps to the assessment process: Check, observe, stimulate, rate. Research has indicated that using the motor scale alone can simplify the assessment process while maintaining the accuracy of the score. The motor scale has proved the most useful for assessment in both older children and preverbal children when studying blunt trauma. There have also been modified scales developed for use in the paediatric population. The Glasgow Coma Scale - Extended (GCS - E) includes the use of an amnesia scale in order to avoid the premature discharge of patients with mild traumatic brain injury. Modified scales have been developed for use in other populations.

It can also be administered in a variety of settings such as pre-hospital, arrival at the emergency department and in the hours following admission, giving it the ability to monitor changes and trends in patient consciousness over time. stroke ( subarachnoid haemorrhage, intracerebral haemorrhage, or ischemic stroke),.Today, it is consistently used for many conditions including: The Glasgow Coma Scale was originally developed to help determine the severity of a coma or dysfunction following a traumatic brain injury, but can be useful for any condition leading to impaired consciousness.

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