How many people use the Glascow Coma Scale?

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surfsidewood

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Hi,

I am doing some research for a product idea that I have and was wondering how many of us use the Glascow Coma Scale?

If so, how often?

Do you have trouble remembering the point system?

And how important do you think it is in the assessment of a head injury patient?

Any info would be greatly appreciated.
 
Required on every patient, as it should be.
 
It's required. I don't have any trouble remembering it, and our ePCR walks you through it anyway.
 
Use it all the time. The only reason I'll ever confuse anything is when transferring info between our company form (which is a complete charlie foxtrot) and the county form, but only because the company form has everything in the wrong order
 
Nearly* every patient.

I don't have a problem remembering it anymore, since I use it so much.

*I say nearly and not always because it doesn't always work well in the very young infant and if I'm doing a transfer home on a sleeping/sedated patient it usually isn't worth it to wake them up to ask "do you know the year?".
 
So when you are handing off the patient to the ER are you giving them a points based score, or are you giving them a general LOC indication based on responses that you saw from the patient?

I really appreciate the info.
 
Depends on the case. Unless their GCS is abnormal I tend to skip it in the oral report. If their GCS is abnormal I explain how, which usually entails listing which LOC questions the pt does or doesn't know. For example "GCS 14, she knows her name and that we are in Timbuktu, but she thinks it is 1992 and I'm her sister".

Again, peds tend to be a little different because of the differences between ages of what "oriented" is. I am more apt to give a subjective description of LOC than a GCS. A developmentally average 2 yo should be talking. If they don't talk to me does that mean they aren't oriented? Not necessarily, I don't always expect the 2yo to talk to the scary stranger in a uniform who poked and prodded them and probably pissed them off by checking their blood sugar. That is where interaction and following directions helps. Now, if we have a 2yo who doesn't talk to me and doesn't interact then I'm concerned about their LOC.
 
Just remember to notify the ED, if the patients GCS is less than 15, what the normal is. always fun to watch a crew tell ED staff that the patient has a GCS of 5: 3,1,1 and forget to tell them that it is the norm for that patient.
 
We have to learn it very good for medic school but in the field ive never used it. EMS charts has it but while in direct patient contact ive never heard and emt or medic use it.
 
In what ways are you involved in EMS? Do you have experience in using the Coma Scale yourself on patients?

Just curious about who's asking and I would like to know a little bit more about what you hope to offer. We might be able to focus a bit better. If you didn't already know it is commonly used and relatively simple, then I'm wondering how we can help you.
 
I'm just a student right now so i don't know how often they use it in the field. It's on our PCR when we run our fake calls, but nobody in my class has really used it usually our patients are conscious. If we don't give them oxygen fast enough they go unconscious. Maybe we will use it as we build up our skills. We are suppost to know it and we have had question on our tests about it. We usually just use AVPU and CAO.
 
GCS is a good rough and ready tool...

But what if one factor changes up and another down, or a reporter's subjectivity is masked by a number? By all means use it to structure an eval and for a fast report, but the receiver needs to get the details, such as the pt has become totally unresponsive, or unless it doesn't matter, such as the pt has recovered or died .
 
firetender said:
In what ways are you involved in EMS? Do you have experience in using the Coma Scale yourself on patients?

Just curious about who's asking and I would like to know a little bit more about what you hope to offer. We might be able to focus a bit better. If you didn't already know it is commonly used and relatively simple, then I'm wondering how we can help you.
Click to expand...

I am a firefighter/EMT in FL, but we are not a transport agency. I've done plenty of ride alongs with the county (who does the transports) but have never seen them use the GCS score. I know how it is used in my local area, but I was basically trying to figure out on more of a National and Global scale if it is a widely used method for measuring severity of head injury. I know that most people know of it because they had to learn it for the NREMT exam, but I am not sure about how many actually use the point system the way it was intended. It seems like it is very different around the country going from mandatory to no use at all. It's interesting to see the variances between EMS providers from different areas, and the different ways that it is used. I believe that the GCS is a very important part of an assessment, especially in a head injury patient, and my product idea would completely simplify the process of assessing for GCS and keeping an accurate score.

The information that I've gotten from this forum has been extremely helpful and I would appreciate any more info everyone has.
 
Nimrod_BasketCase said:
I'm just a student right now so i don't know how often they use it in the field. It's on our PCR when we run our fake calls, but nobody in my class has really used it usually our patients are conscious. If we don't give them oxygen fast enough they go unconscious. Maybe we will use it as we build up our skills. We are suppost to know it and we have had question on our tests about it. We usually just use AVPU and CAO.
Click to expand...

You can use it on conscious patients too.

Have a patient that's x3, able to follow commands, and can open their eyes on their own? 4 5 6 = 15.

What if they're confused, and answer questions inappropriately? 4 4 6 = 14.

Have a dead guy? 1 1 1 = 3.
 
Bilb9494 said:
We have to learn it very good for medic school but in the field ive never used it. EMS charts has it but while in direct patient contact ive never heard and emt or medic use it.
Click to expand...

I'm sure their using it, they may not verbalize it. It isnt a test where you need patient participation, it should take you fifteen seconds to determine a GCS and you can use it as a baseline.
 
surfsidewood said:
Hi,

I am doing some research for a product idea that I have and was wondering how many of us use the Glascow Coma Scale?

If so, how often?

Do you have trouble remembering the point system?

And how important do you think it is in the assessment of a head injury patient?

Any info would be greatly appreciated.
Click to expand...


I use it on every call, as required by policy. One of the service's I work for has a spot for it right on the PCR (along with a scale w/the appropriate numbers relative to pt. response). The other service simply requires that we note the CGS on the PCR when we document our findings.

I don't really have a problem remembering the point system now having done this for the past few years.

With respect to the GCS and its importance in the assessment of a head injury pt., I think that like many other things, its a tool to help (and more importantly, other allied health professionals, like the ER Doc) you build a case for a particular diagnosis/pt. problem. By itself, its simply a number; however, when put together with other information/test results, it can help one to make an informed clinical evaluation.
 
Working in a trauma unit, I use it at least 10x every day.
 
In the field or in the hospital. Every patient. Sometimes multiple times on each patient.

We don't use it as a single number though. Nobody I know says pataint is GCS 14, 8, or whatever, we give the breakdown. Using S for sedated, and T for tubed.

Example: "Mrs. X who is having her elective quadruple bypass at 1030, she is currently in her room, basline GCS, 4,5,6"

"Post OP, Mrs. X's Urine output is good, there is no drainage, heart rate and BP are increasing, currently her GCS is 1, 1, 1 S/T, we hope to have her off the vent in a few hours."

There is also a peds GCS, but to my knowledge it has not been validated.
 
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