The role of glasgow coma scores in the assessment of brain injuries in pre-hospital emergency medical care settings

Abstract

Craniocerebral trauma is a common feature of brain injuries and represents a critical medical issue associated with high rates of mortality and disability. While standards of care for craniocerebral trauma are well-established in hospital settings, there has been less progress in defining such standards in prehospital emergency care contexts. Pre-hospitalization care for these patients typically consists of a medical survey, the administration of basic life support, and professional transport to a hospital. Such care is generally administered by paramedics and other emergency care professionals. Owing to the relatively slow progression of such emergency medical care, rates of treatment success are likely to be affected, with medical surveys of patients being the most important form of pre-hospital care. Indeed, pre-hospital evaluation index values have been shown to correlate with patient prognosis, and as such these index values may be able to better guide the emergency medical treatment of patients upon hospital admission. The Glasgow Coma Scale (GCS) is among the most commonly used tools for the evaluation of brain injury severity, making it an invaluable tool for the assessment of patients suffering from severe trauma in a pre-hospital emergency medical care context. In order to better clarify the relationship between pre-hospital GCS scores and patient prognosis, this review article provides a current overview of the use of GCS scores for the evaluation of craniocerebral trauma patients in a pre-hospital emergency medicine context.