00:00:00Introduction to MEC Expert Insights
00:00:36Glasgow Coma Scale Overview
00:01:50Breaking Down Scale Categories
00:04:40Assessment Challenges and Reliability
00:06:25Episode Conclusion and Contact Info
درباره این اپیزود
The Glasgow Coma Scale (GCS) is one of medicine's most critical assessment tools for traumatic brain injuries. In this episode, “The Glasgow Coma Scale: Setting the Bar for Brain Injury Evaluation," MEC’s Peggy Ford, a Senior National Medical Catastrophe Consultant with over 30 years of experience, provides essential knowledge about how the GCS measures brain injury severity.
Peggy offers valuable insights into this evaluation method, which has become the cornerstone of neurological tests worldwide in emergency settings. It includes a scoring system that allows medical professionals to quickly categorize the severity of brain injuries and make critical treatment decisions in time-sensitive situations where every moment matters. She explains:
- How the scale rates three key aspects of traumatic brain injuries — eye opening, verbal response, and motor response — to generate scores ranging from 3 (completely unresponsive) to 15 (fully alert).
- Why understanding the nuances of each category is essential for accurate assessment.
- The science behind brain injury measurement.
- Factors that can compromise proper evaluation.
Listen now to gain key insights on the importance of standardized assessment tools like the GCS in guiding initial treatment approaches and providing valuable prognostic information for healthcare providers, patients, and families during vital stages of care.
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WEBVTT
00:00:05.370 --> 00:00:13.028
Hello, this is MEC Connect Expert Insights, a companion series to our main MEC Connect podcast for Midwest Employers' Casualty.
00:00:13.028 --> 00:00:25.687
I'm Sara Hance and in these Expert Insights episodes you'll hear from subject matter experts as they share practical tips and strategies on a variety of topics related to workers' comp and claims management.
00:00:25.687 --> 00:00:32.786
Today, Peggy Ford, Senior National Medical Catastrophic Consultant, will discuss the Glasgow Coma Scale.
00:00:32.786 --> 00:00:34.750
Now let's hear from Peggy.
00:00:36.901 --> 00:00:37.323
Good day.
00:00:37.323 --> 00:00:40.694
My name is Peggy Ford from Midwest Employers' Casualty.
00:00:40.694 --> 00:00:44.290
I work as a Senior National Medical Catastrophic Consult consultant.
00:00:44.290 --> 00:00:50.432
I want to share some of my experience over the past 30 plus years working in the workers' compensation arena.
00:00:50.432 --> 00:00:55.731
Today I'm going to give you a quick working knowledge regarding the Glasgow Coma Scale.
00:00:57.222 --> 00:01:09.251
The Glasgow Coma Scale is almost universally utilized to assist in determining the extent of an injured person's loss of consciousness with a brain injury for individuals over the age of five.
00:01:09.251 --> 00:01:18.289
Earc published in 1974 by neurosurgeon professors at the University of Glasgow, graham Teasdale and Brian Jennett.
00:01:18.289 --> 00:01:25.070
It is considered simple, reliable and correlates well with outcome following brain injury.
00:01:25.070 --> 00:01:31.572
After injury, the Glasgow Coma Scale will be repeated if needed and the score updated.
00:01:31.572 --> 00:01:39.768
It should be stated here that traumatic brain injury is a leading cause of death and disability in the United States and around the world.
00:01:39.768 --> 00:01:51.972
The scores are divided into three aspects of responsiveness with the goal of providing a clear, communicable picture that will assist in determining emergent treatment.
00:01:51.972 --> 00:02:01.331
However, one must also address that a prediction of outcome after traumatic brain injury will vary based on the multiple factors of the individual.
00:02:01.331 --> 00:02:07.682
However, we do need to have a starting point and the Glasgow Coma Scale provides that assistance.
00:02:07.682 --> 00:02:15.034
Eye-opening, motor and verbal are the three categories that are utilized.
00:02:15.034 --> 00:02:20.164
The lowest score is 3, and the best score is 15.
00:02:20.164 --> 00:02:30.096
A score from 3 to 8 is considered a severe traumatic brain injury, with poor outcomes and mortality rates as high as 76%.
00:02:30.096 --> 00:02:33.931
9 to 12 is considered moderate.
00:02:33.931 --> 00:02:38.780
This group will usually have favorable outcomes 75% after treatment.
00:02:38.780 --> 00:02:48.370
If you score between 13 and 15, that's considered a mild traumatic brain injury and you usually have a full to good recovery.
00:02:50.042 --> 00:02:51.427
Now let's break down the categories.
00:02:51.427 --> 00:03:07.955
There are four numbers for eye opening and they range from 1 to no eye opening, 2, open to pain stimulus, 3, open to sound and four spontaneous opening.
00:03:07.955 --> 00:03:12.665
There are five numbers assigned for a verbal response.
00:03:12.665 --> 00:03:15.391
One is no verbal response.
00:03:15.391 --> 00:03:24.396
Two it's garbled speech or incomprehensible, in other words, it's not understandable in what they are trying to communicate.
00:03:24.396 --> 00:03:29.820
Three is inappropriate words utilized for the subject matter.
00:03:29.820 --> 00:03:39.437
Four is confused either an inappropriate response or asking questions, and five is considered oriented.
00:03:42.391 --> 00:03:46.913
There are six categories from BODER, one being no motor response.
00:03:46.913 --> 00:03:59.331
Two is an abnormal extension to pain, so, for instance, the head is extended, arms and legs are extended and internally rotated.
00:03:59.331 --> 00:04:09.485
Three is an abnormal flexion to pain and the flexor response is to pull away from pain, in this case, the arms respond in a less purposeful way.
00:04:09.485 --> 00:04:18.435
There may be rotations of the shoulders and the arms and wrists, and the movements of the arms do not go above nipple height.
00:04:18.435 --> 00:04:19.697
Four is withdrawing from pain.
00:04:19.697 --> 00:04:27.819
Five is localizing pain, for instance reaching toward the site where the painful stimulus is being applied.
00:04:27.819 --> 00:04:39.552
And six is obeying commands.
00:04:39.572 --> 00:04:42.956
Now, going with this information, a person with a Glasgow Coma Scale of three would be totally unresponsive.
00:04:42.956 --> 00:04:49.586
A person with a Glasgow Coma Scale of seven could be eyes open to sound, inappropriate word usage and withdrawal from pain.
00:04:49.586 --> 00:04:53.079
15 is the optimal score.
00:04:53.079 --> 00:04:59.543
Your eyes respond pain-free, opening, you're oriented and you obey commands without issue.
00:05:01.329 --> 00:05:40.242
Now, one area is that there are several factors that may interfere with assessment, and this includes language barriers, intellectual or neurological deficits, hearing or speech impediment, low blood oxygen, shock if the person's intubated, if they have any fractures, use of medication and alcohol that could alter consciousness, if they have spinal cord damage, eye injury, damage, any comorbidities that would interfere, and if they have a psychological status that would interfere.
00:05:40.242 --> 00:05:49.170
There's a myriad of areas that can impact each single person differently.
00:05:49.170 --> 00:05:54.560
The Glasgow Coma Scale has been studied extensively, with 85% of studies showing substantial reliability.
00:05:54.560 --> 00:06:01.338
Reproducibility of the number determined upon assessment is also demonstrated by others completing an assessment.
00:06:01.338 --> 00:06:11.603
However, there are always movements to provide a more advanced technique to provide data, but for now, the Glasgow Coma Scale is the preferred method.
00:06:11.603 --> 00:06:14.396
Thank you for listening today.
00:06:14.396 --> 00:06:21.980
I hope you learned some additional or new tidbits regarding the Glasgow Coma Scale and this information was of assistance to help your understanding.
00:06:21.980 --> 00:06:25.716
If you have any further questions, please feel free contacting me.
00:06:28.283 --> 00:06:30.026
Thank you for tuning in to MEC Connect Expert Insights.
00:06:30.026 --> 00:06:31.290
Any further questions, please feel free contacting me.
00:06:31.290 --> 00:06:33.218
Thank you for tuning in to MEC Connect Expert Insights.
00:06:33.218 --> 00:06:37.338
Here at MEC, we focus on what matters most worker recovery and better claims outcomes.
00:06:37.338 --> 00:06:45.954
Our skilled people, proven processes and innovative technology achieve measurable results and creates lasting value.
00:06:45.954 --> 00:06:50.552
We hope you found Peggy's insights on the Glasgow Coma Scale valuable.
00:06:50.552 --> 00:06:55.362
Stay tuned for more from MEC Connect and more expert insights.
00:06:55.362 --> 00:06:56.836
Thank you for listening.
00:00:05.370 --> 00:00:13.028
Hello, this is MEC Connect Expert Insights, a companion series to our main MEC Connect podcast for Midwest Employers' Casualty.
00:00:13.028 --> 00:00:25.687
I'm Sara Hance and in these Expert Insights episodes you'll hear from subject matter experts as they share practical tips and strategies on a variety of topics related to workers' comp and claims management.
00:00:25.687 --> 00:00:32.786
Today, Peggy Ford, Senior National Medical Catastrophic Consultant, will discuss the Glasgow Coma Scale.
00:00:32.786 --> 00:00:34.750
Now let's hear from Peggy.
00:00:36.901 --> 00:00:37.323
Good day.
00:00:37.323 --> 00:00:40.694
My name is Peggy Ford from Midwest Employers' Casualty.
00:00:40.694 --> 00:00:44.290
I work as a Senior National Medical Catastrophic Consult consultant.
00:00:44.290 --> 00:00:50.432
I want to share some of my experience over the past 30 plus years working in the workers' compensation arena.
00:00:50.432 --> 00:00:55.731
Today I'm going to give you a quick working knowledge regarding the Glasgow Coma Scale.
00:00:57.222 --> 00:01:09.251
The Glasgow Coma Scale is almost universally utilized to assist in determining the extent of an injured person's loss of consciousness with a brain injury for individuals over the age of five.
00:01:09.251 --> 00:01:18.289
Earc published in 1974 by neurosurgeon professors at the University of Glasgow, graham Teasdale and Brian Jennett.
00:01:18.289 --> 00:01:25.070
It is considered simple, reliable and correlates well with outcome following brain injury.
00:01:25.070 --> 00:01:31.572
After injury, the Glasgow Coma Scale will be repeated if needed and the score updated.
00:01:31.572 --> 00:01:39.768
It should be stated here that traumatic brain injury is a leading cause of death and disability in the United States and around the world.
00:01:39.768 --> 00:01:51.972
The scores are divided into three aspects of responsiveness with the goal of providing a clear, communicable picture that will assist in determining emergent treatment.
00:01:51.972 --> 00:02:01.331
However, one must also address that a prediction of outcome after traumatic brain injury will vary based on the multiple factors of the individual.
00:02:01.331 --> 00:02:07.682
However, we do need to have a starting point and the Glasgow Coma Scale provides that assistance.
00:02:07.682 --> 00:02:15.034
Eye-opening, motor and verbal are the three categories that are utilized.
00:02:15.034 --> 00:02:20.164
The lowest score is 3, and the best score is 15.
00:02:20.164 --> 00:02:30.096
A score from 3 to 8 is considered a severe traumatic brain injury, with poor outcomes and mortality rates as high as 76%.
00:02:30.096 --> 00:02:33.931
9 to 12 is considered moderate.
00:02:33.931 --> 00:02:38.780
This group will usually have favorable outcomes 75% after treatment.
00:02:38.780 --> 00:02:48.370
If you score between 13 and 15, that's considered a mild traumatic brain injury and you usually have a full to good recovery.
00:02:50.042 --> 00:02:51.427
Now let's break down the categories.
00:02:51.427 --> 00:03:07.955
There are four numbers for eye opening and they range from 1 to no eye opening, 2, open to pain stimulus, 3, open to sound and four spontaneous opening.
00:03:07.955 --> 00:03:12.665
There are five numbers assigned for a verbal response.
00:03:12.665 --> 00:03:15.391
One is no verbal response.
00:03:15.391 --> 00:03:24.396
Two it's garbled speech or incomprehensible, in other words, it's not understandable in what they are trying to communicate.
00:03:24.396 --> 00:03:29.820
Three is inappropriate words utilized for the subject matter.
00:03:29.820 --> 00:03:39.437
Four is confused either an inappropriate response or asking questions, and five is considered oriented.
00:03:42.391 --> 00:03:46.913
There are six categories from BODER, one being no motor response.
00:03:46.913 --> 00:03:59.331
Two is an abnormal extension to pain, so, for instance, the head is extended, arms and legs are extended and internally rotated.
00:03:59.331 --> 00:04:09.485
Three is an abnormal flexion to pain and the flexor response is to pull away from pain, in this case, the arms respond in a less purposeful way.
00:04:09.485 --> 00:04:18.435
There may be rotations of the shoulders and the arms and wrists, and the movements of the arms do not go above nipple height.
00:04:18.435 --> 00:04:19.697
Four is withdrawing from pain.
00:04:19.697 --> 00:04:27.819
Five is localizing pain, for instance reaching toward the site where the painful stimulus is being applied.
00:04:27.819 --> 00:04:39.552
And six is obeying commands.
00:04:39.572 --> 00:04:42.956
Now, going with this information, a person with a Glasgow Coma Scale of three would be totally unresponsive.
00:04:42.956 --> 00:04:49.586
A person with a Glasgow Coma Scale of seven could be eyes open to sound, inappropriate word usage and withdrawal from pain.
00:04:49.586 --> 00:04:53.079
15 is the optimal score.
00:04:53.079 --> 00:04:59.543
Your eyes respond pain-free, opening, you're oriented and you obey commands without issue.
00:05:01.329 --> 00:05:40.242
Now, one area is that there are several factors that may interfere with assessment, and this includes language barriers, intellectual or neurological deficits, hearing or speech impediment, low blood oxygen, shock if the person's intubated, if they have any fractures, use of medication and alcohol that could alter consciousness, if they have spinal cord damage, eye injury, damage, any comorbidities that would interfere, and if they have a psychological status that would interfere.
00:05:40.242 --> 00:05:49.170
There's a myriad of areas that can impact each single person differently.
00:05:49.170 --> 00:05:54.560
The Glasgow Coma Scale has been studied extensively, with 85% of studies showing substantial reliability.
00:05:54.560 --> 00:06:01.338
Reproducibility of the number determined upon assessment is also demonstrated by others completing an assessment.
00:06:01.338 --> 00:06:11.603
However, there are always movements to provide a more advanced technique to provide data, but for now, the Glasgow Coma Scale is the preferred method.
00:06:11.603 --> 00:06:14.396
Thank you for listening today.
00:06:14.396 --> 00:06:21.980
I hope you learned some additional or new tidbits regarding the Glasgow Coma Scale and this information was of assistance to help your understanding.
00:06:21.980 --> 00:06:25.716
If you have any further questions, please feel free contacting me.
00:06:28.283 --> 00:06:30.026
Thank you for tuning in to MEC Connect Expert Insights.
00:06:30.026 --> 00:06:31.290
Any further questions, please feel free contacting me.
00:06:31.290 --> 00:06:33.218
Thank you for tuning in to MEC Connect Expert Insights.
00:06:33.218 --> 00:06:37.338
Here at MEC, we focus on what matters most worker recovery and better claims outcomes.
00:06:37.338 --> 00:06:45.954
Our skilled people, proven processes and innovative technology achieve measurable results and creates lasting value.
00:06:45.954 --> 00:06:50.552
We hope you found Peggy's insights on the Glasgow Coma Scale valuable.
00:06:50.552 --> 00:06:55.362
Stay tuned for more from MEC Connect and more expert insights.
00:06:55.362 --> 00:06:56.836
Thank you for listening.
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