As stated in the November TBI tip, traumatic brain injuries can be mild, moderate or severe. Before you can understand the classification of a brain injury, it is important to understand the “rating” system called the Glasgow Coma Scale, otherwise referred to as GCS. This scale is a universally applied measure, indicating the severity of the brain injury. The “grade” is determined as early as at the scene of the injury, or in the Emergency Room . The GCS assigns a numerical value to patient reactions in three areas; eye opening, body movement, and speech. Each area is assigned a number and when added together, the Glasgow Coma Score for the patient is assigned. The ideal total score is 15. The severity of the injury is based on the score received. The Glasgow Coma Scale is as follows:
Eye Opening:
Opens eyes spontaneously: 4
Opens eyes to speech: 3
Opens eyes to pain: 2
Does not open eyes: 1
Body Movement:
Obeys simple commands: 6
Attempts to move from pain: 5
Withdraws from pain: 4
Moves muscles abnormally: 3
Moves muscles involuntarily: 2
Does not respond to pain: 1
Speech:
Speaks clearly and appropriately: 5
Converses with confusion: 4
Uses inappropriate words: 3
Makes incomprehensible sounds: 2
Makes no sounds: 1
After evaluation, the score for each area is added. The total score becomes a broad measure of how well a TBI victim will recover.
13-15 Mild Brain injury
9-12 Moderate Brain Injury
3-8 Severe Brain Injury
However, based on my personal experience with TBI victims, I have seen that predicting long term outcome can be “risky”. Patients have surprised medical personnel for many years. A high score doesn’t necessarily mean a favorable outcome and a low score doesn’t necessarily indicate a poor outcome. As you will often hear me say…THERE’S ALWAYS HOPE!
Dar Warner, L.P.N., C.B.I.S. can be reached at darwarner@dobsonhealthcare.com or by calling (866) 866-8984