Glasgow coma scale: Origin, analysis, and appropriate use

Abstract

Introduction: Nurses are frequently responsible of immediate classification and initial assessment of patients suffering from a cranium encephalic traumatism. Early acknowledgement of brain damage signs is fundamental to offer timely treatments.

Objective: To identify the usefulness of the Glasgow Coma Scale, and determine its appropriate use by the nursing staff.

Methods: Information search was performed through 3 main health databases: Medline, CINHAL and BVS. The search words used were Glasgow coma scale, brain injuries, coma, trauma severity, nursing assessment, and neurologic assessment. The search was limited to 10 years, and considering only in the adult population.

Results: The Glasgow Coma Scale is a highly sensible instrument to assess patients with some de- gree of brain injuries. some failures and inconsistencies in its use and interpretation have been observed, such as supposing worse clinical conditions than the real ones, or on the other hand, underestimate the neurological impairment; however, it has been demonstrated that a continuous training on the use of this scale significantly improves the assessments and the results outcomes.

Conclusions: The Glasgow Coma Scale has 3 sub-scales which individually estimate 3 aspects of consciousness: ocular aperture, verbal response, and motor response. The final score is made up with the best responses in the 3 sub-scales. The objective is to alert the medical and nursing staff regarding any neurologic alteration in the patient. The scale has a common and objective language in order to improve the communication from the results, and at present, it is the most widely used parameter both in the hospital and pre-hospital scenarios.