A while ago we wrote about the Glasgow Coma Scale and how it can´t be relied on for trauma patients or in emergency medicine in the acute phase. We based it on an excellent editorial written by a Dr Stephen Greene. Now a study in EMJ seems to confirm Dr Greenes concerns. This time they tested the people who really should know the GCS, paramedic students.
A prospective double-blinded observational study. Monash University paramedic students were exposed to four DVD recordings of four patients who displayed various GCS scores. The students had previously been exposed to a lecture, turorials and mannequin training in order to teach them how to calculate GCS scores.
The study demonstrated how students struggled with the two patients who had GCSs in the low- to mid-range score of GCS 7 and 12. Only 20% and 37% accurately scored these patients correctly.
What will it take for this, at least in emergency medicine, abomination to go away?
Our previous thoughts on GCS lives here.
The study from Monash contaoins an excellent discussion of the strengths and weaknesses of the GCS and you should probably read it.