Inaccuracy and misjudged factors of glasgow coma scale scores

Traumatic brain injury and other neurological disorders are primarily assessed using the Glasgow Coma Scale (GCS) to evaluate consciousness. However, GCS score assignment is far from sufficiently reliable for correct assessment, especially with inexperienced users. In this chapter, we reveal what factors of the GCS are misjudged when assessed by inexperienced medical personnel. We analyzed GCS eye, verbal, and motor response (EVM) scoring profiles conducted by postgraduate year 1 junior residents (n = 94) before they began residency in specific departments. GCS assessment was tested using a video simulation that portrayed mock patients with eight different levels of consciousness that are frequently encountered in trauma patients at the emergency department. On average, 26% ± 18% of examinees failed to provide the correct EVM profiles for the eight selected consciousness levels. Primary misjudged GCS factors belonged to two categories: the assessment of " confused conversation (verbal score of 4) ", and the assessment of "withdrawal motor response (motor score of 4)". Additional instruction regarding the specific misjudged factors described in this chapter may help inexperienced medical personnel improve the reliability of GCS score assignment to casualties or patients with consciousness disturbance.