“The Glasgow Coma Scale (GCS) is a measure of how severe a brain injury is.

 It is calculated either at the scene of the injury or in the emergency room. The GCS also is used with patients who remain unconscious for days, weeks, or months to gauge the depth of their coma and assess whether they are improving or deteriorating.

The GCS assigns a numerical value to the patient’s reaction to an attention-grabbing event, such as a jab with a pin or a shouted command, in three areas: eye opening, body movement, and speech. Add the scores of these three areas, as indicated below, to obtain a number that varies from 3 (the worst response) to 15 (the best response).

         Glasgow Coma Scale = Eye Opening + Body Movement + Speech

Eye Opening

            Opens eyes spontaneously                    4

            Opens eyes to speech                           3

            Opens eyes to pain                               2

            Does not open eyes                              1

Body Movement

            Obeys simple commands                      6

            Attempts to move from pain                  5

            Withdraws from pain                            4

            Moves muscles abnormally                   3

            Moves muscles involuntarily                  2

                                    Does not respond to pain                      1

Speech

            Speaks clearly and appropriately           5

            Converses with confusion                      4

            Uses inappropriate words                     3

            Makes incomprehensible sounds           2

            Makes no sounds                                 1

Warning: The GCS is a broad measure of how well patients will recover. Its predictive value for any single individual—your survivor for example—is suspect. Predicting the long-term outcome of a brain injury is riskier than roulette.

Some doctors don’t share GCS scores with the family, particularly if the score is low. They argue that the additional bad news of a low GCS score heightens the family’s anguish without providing any useful information. But the old-school physicians of the past—“Let me worry about the numbers, little lady”—have been overtaken by the information age. Don’t be surprised if your computer-savvy teenager greets you at home asking, “What’s Mom’s GCS?”

Remember, every brain injury is unique and unpredictable. Not everyone with a low GCS has a bad outcome. Not everyone with a high GCS has a good outcome. Many factors determine how well a person recovers from a brain injury. Countless survivors with low GCS scores now lead full and productive lives. They include mothers and fathers, sons and daughters, and husbands and wives who relish each day, enjoy loving relationships, and bring joy to those around them. The Glasgow Coma Scale is just one tool in a doctor’s medical bag and just one more piece of information you can use to better comprehend your survivor’s condition”.

For the past six years, Garry Prowe has been asking survivors of life-altering brain injuries and their families what it means to successfully survive a brain injury and how one achieves success. Garry’s book, “Successfully Surviving a Brain Injury”, which is based not only on this research, but also his experiences caring for his wife, Jessica, who acquired a brain injury eleven years ago, will be out soon. If you would like to participate in the project, please visit his website at www.BrainInjurySuccess.org.