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The Glasgow Coma Scale - A Valuable Tool for First Responders and Attorneys

When an individual receives a traumatic brain injury, it is important to utilize a series of tests to determine the level of damage and the expected impairment of the individual in the future. One of the most widely used tests is known as the Glasgow Coma Scale (GCS). This test uses three different numerical ratings to determine a victim's level of consciousness. First responders such as EMT's may use this test as well as medical doctors and emergency room personnel. The importance to the first responder is that it helps to determine the best facility in which to transport the victim and to notify emergency room personnel of the results so they can prepare to deal with the level of injury.

The GCS is not only a way for medical professionals to gain instant access to the type and level of injury, it is also an effective way for attorneys to ascertain the time and severity of injury and the future prognosis of the patient.

The Three GCS Factors

The Glasgow Coma Scale uses three different measurements and scores them per response

Eye Opening Response

· Spontaneous 4

· To voice 3

· To pain 2

· No response 1

Verbal Response

· Oriented to time place and person 5

· Confused, disoriented conversation 4

· Incoherent words 3

· No words, only sounds 2

· No response 1

Motor Response

· Normal 6

· Localized to pain 5

· Withdraws to pain 4

· Decorticate posture 3

· Decerebrate posture 2

· No response 1

Assessing the Score on the Glasgow Coma Scale

The aggregate scores of the test are used to assess the level of damage to a person's brain. The injury is classified by combining the three separate scores

· Severe Brain Injury: GCS 3-8

· Moderate Brain Injury: GCS 9-12

· Mild Brain Injury: GCS 13-15

Please note that the Glasgow Coma Scale is used for adults who have suffered brain injuries. A modified version called the Pediatric Glasgow Coma Scale is used for children under 36 months who may not form sentences from words.

A person who scores a GCS 3 would be comatose and show little chance of recovery. A normal person would show a score of GCS 15. Doctors are aware that the overall GCS can be affected by other aspects of the patient or their injuries. Separate injuries may impair the response to pain such as a spinal injury. A person who is intoxicated may not speak coherently at the time the test is given. While exceptions do exist, a GCS score of 8 or lower generally indicates a severe brain injury; 9-12 indicates a moderate injury: and 13 to 15 indicates a mild injury. A patients GCS score can improve over time as the patient recovers.

Another test that is used widely for measuring patients who suffered brain injuries is the Rancho Los Amigos Scale (RLS) named for a Los Angeles trauma center. The RLS differs from the GCS as it is used to measure the progress of recovery as opposed to the severity of the injury. It is not intended to predict the outcome of treatment.

The Value of the Glasgow Coma Scale to the Brain Injury Attorney

When an accident occurs due to the negligence of another, resulting in a traumatic brain injury, the victim or the victim's loved ones have the right to recover damages to cover medical expenses, past and future lost wages, permanent disability or disfigurement, pain and suffering and more. A traumatic brain injury is often catastrophic and life changing for the victim and their family. For a case to be successful four points must be satisfied; duty of care, breach of duty, causation and injury. Causation and injury are supported by the results of the GCS. The test shows that the accident occurred, the accident caused the injuries and the injuries were severe.

When first responders arrive at the scene and perform the Glasgow Coma Scale evaluation, several factors are evident. The level of consciousness of the injured party, the apparent extent of a brain injury and the time and place that the injury occurred. Having the record of the first responders GCS score helps to satisfy the required points to have a sound case. The level of injury was severe and it occurred at the time of the accident and the recovery may be long and never complete. Other tests such as CAT scans, as well as professional neurological assessment, help to reinforce the initial determination.

The Devastating Effects of a Traumatic Brain Injury

When an individual is in an accident resulting in a traumatic brain injury, both the victim and family members may be affected for a lifetime. The injured individual may never be able to provide for the family and require years of rehabilitation and retraining just to learn basic skills like walking, speaking, reading and eating independently. Only a qualified brain injury attorney should be retained to represent the victim and family in cases of traumatic brain injury. The traumatic brain injury attorney knows that the cost of a brain injury can be in the millions of dollars over a lifetime and will vehemently fight to recover the true value of the case. Having all the medical records and the testimony of experts is the first important step to a successful outcome.

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