Traumatic brain injuries (TBIs) are more common than most people think. Based on data from the Centers for Disease Control and Prevention (CDC), there were approximately 214,110 TBI-related hospitalizations in 2020 and 69,473 TBI-related deaths in 2021. This represents 586 and 190 TBI-related hospitalizations and TBI-related deaths, respectively, every day.
One of the primary tools used to evaluate brain injuries after motor vehicle crashes, workplace accidents, and slips and falls is the Glasgow Coma Scale (GCS). But what exactly is this scale, and how does it work? What’s its relevance in the medical and legal fields?
What Is the Glasgow Coma Scale?
The Glasgow Coma Scale is a tool used to “score” or measure a person’s level of consciousness. This 15-point test helps trauma medical personnel and doctors gauge the initial severity of a victim’s traumatic brain injury, giving numbered scores of one’s responses.
The GCS, developed in 1974 by neurosurgeons at the University of Glasgow in Scotland, is a preferred method for assessing trauma in patients with head injuries. This simple and reliable test helps doctors make medical determinations and plan treatments for accident victims.
[This source in brackets because it’s a possible search competitor: https://my.clevelandclinic.org/health/diagnostics/24848-glasgow-coma-scale-gcs]
When Is the Glasgow Coma Scale Used?
Doctors use this scale as part of a neurological exam. Physicians also employ this tool in trauma centers, emergency departments, and intensive care units to determine whether patients have sustained concussions or traumatic brain injuries.
The GCS also helps with non-injury-related conditions, such as poisoning, low blood sugar, and seizures.
What Does the Glasgow Coma Scale Measure?
Using three categories, the Glasgow Coma Scale’s neurological exam measures a patient’s consciousness. The exam mainly applies to the brain, but some of the tests involve your spinal cord and nerves. To calculate an accident victim’s level of consciousness, the scale measures:
- Eye response: Are you awake and alert? When prompted, do you open your eyes?
- Verbal response: How well can your brain control muscle movement? Can you construct sentences and answer questions correctly?
- Motor response: How do you respond to things happening in your surroundings? Can you follow commands?
The scores of this test can help determine the severity of the TBI and potential issues the brain injury is causing.
How Does the Glasgow Coma Scale Work?
To get your score, doctors combine the scores from three GCS categories. They will test each of the categories in various ways. For example, they can test your verbal responses by asking what city you are currently in or what day of the week it is. The higher your GCS score, the more conscious and alert you are. Scores are adjusted for people with disabilities that preceded the injury.
The scale measures the following functions when assessing a patient’s brain injury:
Eye Response
| Eye Response Score | Score Meaning |
| 4 | Eyes open spontaneously |
| 3 | Eyes open in response to voice |
| 2 | Eyes open in response to stimuli, such as touch or pain |
| 1 | Eyes do not open in response to anything |
Verbal Response
| Verbal Response Score | Score Meaning |
| 5 | Oriented and converses normally |
| 4 | Confused and disoriented |
| 3 | Talks but is incoherent |
| 2 | Makes sounds or noises, such as moans and groans |
| 1 | No audible response |
Motor Response
| Motor Response Score | Score Meaning |
| 6 | Follows instructions regarding when and how to move |
| 5 | Intentionally moves away from objects pressing on them |
| 4 | Moves away from objects pressing on them as a reflex |
| 3 | Pulls inward in response to pressure |
| 2 | Stretches outward in response to pressure |
| 1 | No movement in response to pressure |
Interpretation of GCS Scores
A patient’s scores are typically documented on a coma scale chart, allowing doctors to observe improvements or deterioration of their condition. Once the medical professionals are done with the exam, the scores are summed up to shed light on the patient’s condition as follows:
- Mild brain injury: GCS score of 13-15
- Moderate brain injury: GCS score of 9-12
- Severe brain injury: GCS score of 8 or less
The highest possible score is 15, and the lowest is 3. A score of 15 means you are fully responsive and awake and have no issues with memory or thinking.
What Are the Limitations of the Glasgow Coma Scale?
Various things can affect and interfere with GCS tests and scores, including:
- Pre-existing factors: Issues such as hearing loss, language barriers, neurological disability, and speech impediments that were in place before the head trauma can prevent a patient from following directions or responding.
- Current treatments: If the patient is sedated or undergoing intubation, they could fail to respond appropriately.
- Other injuries: A spinal cord injury or fractured skull that a patient sustains in the same accident can make it impossible for them to respond accurately.
Being on drugs or drunk, shock, low blood sugar, and low blood pressure can also affect an accident victim’s consciousness and lead to false GCS scores.
What Are the Legal Implications of the Glasgow Coma Scale?
Scores from the GCS play a critical role not only in the diagnosis and treatment of brain injuries but also in personal injury cases. Brain injury lawyers often use GCS scores to demonstrate the severity of an accident victim’s injuries in two contexts:
- Proving negligence: The GCS score can help to prove the defendant’s negligence in an injury case.
- Determining damages: A low score on the Glasgow Coma Scale can be used as evidence to push for higher compensation for medical bills, lost wages, pain and suffering, and other damages. Such a score implies the injured victim’s brain injury is severe.
Sustained a Brain Injury in an Accident? Contact a Personal Injury Lawyer
If you or your loved one has suffered a TBI in a car accident or in the workplace, understanding the GCS is just the beginning. Brain injuries and the legal claims that follow can be very complex and challenging to navigate. An experienced brain injury lawyer can help you focus on healing and recovery rather than fighting battles against insurance companies or in court. Seeking legal counsel and representation can help you secure the best possible compensation after an accident.
