The GCS assesses a person based on their ability to perform eye movements, speak, and move their body.
This score is used to guide immediate medical care after a brain injury (such as a car accident) and also to monitor hospitalised patients and track their level of consciousness.
The Glasgow Coma Scale is used for people above the age of two and is composed of three tests: eye, verbal, and motor responses.
The results are reported as the Glasgow Coma Score (the total points from the three tests) and the individual components.
[8] Generally, brain injury is classified as: Tracheal intubation and severe facial/eye swelling or damage make it impossible to test the verbal and eye responses.
This would mean, for example, eyes closed because of swelling = 1, intubated = 1, leaving a motor score of 3 for "abnormal flexion".
The GCS has limited applicability to children, especially below the age of 36 months (when the verbal performance of even a healthy child would be expected to be poor).
A number of assessments for head injury ("coma scales") were developed, though none were widely adopted.
Third, the scale needed to provide important information for managing a patient with a head injury.
[1] In 1976, Teasdale updated the motor component of the Glasgow Coma Scale to differentiate flexion movements.
[20] However, later work demonstrated that the sum of the GCS components, or the Glasgow Coma Score, had clinical significance.
[20] First, Tom Langfitt, a leading figure in neurological trauma, wrote an editorial in Journal of Neurosurgery strongly encouraging neurosurgical units to adopt the GCS score.
[24] The GCS has come under pressure from some researchers who take issue with the scale's poor inter-rater reliability and lack of prognostic utility.
[26] Although the inter-rater reliability of these newer scores has been slightly higher than that of the GCS, they have not yet gained consensus as replacements.