It is time to abandon the Glasgow Coma Scale (GCS). As discussed below, this ubiquitous neurologic scoring system is confusing, unreliable, and unnecessarily complex, and its manner of common clinical use is statistically unsound. Teasdale and Jennett devised the GCS in 1974 not for acute care, but rather for the “repeated bedside assessment” in a neurosurgical unit to detect “changing states” ...

OBJECTIVE To identify in mild head injured children the major differences between those with a Glasgow Coma Scale (GCS) 15 and GCS 13/14. METHOD Cross-sectional study accomplished through information derived from medical records of mild head injured children presented in the emergency room of a Pediatric Trauma Centre level I, between May 2007 and May 2008. RESULTS 1888 patients were includ...

Numerous scoring scales have been proposed and validated to evaluate coma for rapid pre-hospital assessment and triage, disease severity, and prognosis for morbidity and mortality. These scoring systems have been predicated on core features that serve as a basis for this review and include ease of use, inter-rater reliability, reproducibility, and predictive value. Here we review the benefits a...

Pharmacokinetic/pharmacodynamic (PK/PD) relationships describe the quantitative relationships between the drug-induced effects and the concurrent corresponding drug concentrations in an individual. Since a long time, rough qualitative relationships have been described between neurological presentation and plasma ethanol concentration in acute ethanol ingestion. However, to date, precise quantit...

Introduction: Accurate evaluation of the extent and severity of neurologic injury is a key component in the care of the trauma patient as traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality in trauma victims. EMS assessment of the severity of such injury affects such decisions as need for transfer to a trauma center. Currently, the Glasgow Coma Scale (GCS) is th...

AIM Glasgow Coma Scale (GCS) is the most applied tool for classifying intensity of coma and predicting patient outcomes with traumatic brain injuries. The present study was conducted with the aim of comparing two criteria of Full Outline of UnResponsiveness (FOUR) scale and GCS in predicting prognosis in patients with traumatic brain injuries. MATERIAL AND METHODS In this prospective study, 1...

Introduction. The verbal, eye, and motor components of Glasgow coma scale (GCS) may be influenced by poisoned patients' behavior in an attempted suicide. So, the values of admission GCS and its components for outcomes prediction in mixed drugs poisoning were investigated. Materials and Methods. A followup study data was performed on patients with mixed drugs poisoning. Outcomes were recorded as...

Objective To verify correlations between age, injury severity, length of stay (LOS), cognition, functional capacity and quality of life (QOL) six months after hospital discharge (HD) of victims of traumatic brain injury (TBI). Method 50 patients consecutively treated in a Brazilian emergency hospital were assessed at admission, HD and six months after HD. The assessment protocol consisted in Ab...

A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic...