The Glasgow Coma Scale: time for change

Abstract

Objective: To summarize and evaluate evidence on the psychometric properties of the Glasgow Coma Scale (GCS).

Results: This instrument attempts to capture the phenomenon of consciousness with three gross indicators of nervous system function. Although the GCS does capture consciousness to a limited extent and has pragmatic utility for practitioners, it suffers serious limitations for clinical monitoring and prediction and is being eclipsed by a variety of other instruments.

Conclusion: In spite of its acknowledged shortcomings and the emergence of parallel instruments with greater reliability and validity, the GCS continues to enjoy a privileged, but unwarranted, position in clinical and investigational contexts.