The Glasgow Coma Scale: A Breakthrough in the Assessment of the Level of Consciousness

Abstract

The Glasgow Coma Scale (GCS) was introduced in 1974 as a measure of a patient’s level of consciousness. Before the development of this scale the level of consciousness was described by the terms like stuperose, comatose, semicomatose, obtunded, decerebrate etc. These terms were ill-defined, confusing and not comparable between different observers. The GCS is a simple and reliable measure of level of consciousness. Once the medical and nursing staff is trained, the inter-observer variability is low. This scale went on to be accepted and used by most of the neurosurgical unit worldwide. The institute of Neurological sciences Glasgow is a world leader, in brain injury research and clinical care. In 1974, Professor Jennet and Mr. Teasdale of this institute published a paper in the lancet on the assessment of Coma and impaired consciousness. This paper proposed a structured method of assessment called “the Glasgow Coma Scale”. GCS is a component of the acute physiology and chronic health evaluation (APACHE) II score, the (revised) trauma score, the trauma and injury severity score (TRISS) and Circulation, Respiration, Abdomen, Motor, Speech (CRAMS) Scale, demonstrating the world wide adaptation of the scale.