| Traumatic brain injury (TBI) can result in a number of | | | | * No motor response (1). |
| differing effects in victims, including loss of | | | | After assessing numbers for each area, the |
| consciousness and even coma. Published in 1974 by | | | | practitioner adds them together for a final score. A |
| neurosurgeons Bryan J. Jennett and Graham Teasdale | | | | score of eight or under indicates that the patient is in |
| of the University of Glasgow, the Glasgow Coma | | | | a coma; at least 50 percent of patients at an eight |
| Scale is a tool doctors use to assess a patient's | | | | score or lower more than six hours after TBI will die. |
| consciousness. When doctors wish to assess a brain | | | | A score of 9 to 11 indicates a moderate coma or |
| injury patient's recovery, they turn to the Rancho | | | | injury, while a score of 12 or higher means a |
| Los Amigos Scale, which was developed by head | | | | moderate injury. |
| injury treatment specialists at a California hospital in | | | | The Rancho Los Amigos Scale |
| order to assess a patient's progression during the | | | | The Rancho Los Amigos Scale was developed to |
| traumatic brain injury rehabilitation process. | | | | help practitioners, families and therapists to |
| The Glasgow Coma Scale | | | | understand a brain injury victim's progression through |
| The Glasgow Coma Scale allows doctors to place a | | | | the rehabilitation process. Though it stipulates "levels" |
| numerical value on the amount of consciousness they | | | | of recovery, it is possible for patients to exhibit |
| perceive in a brain-injured patient. It is essentially a | | | | characteristics of different levels simultaneously, and |
| mathematical formulation in which motor response, | | | | plateaus are common in recovery. The scale is not |
| verbal response and eye opening are added together | | | | intended to predict outcomes of traumatic brain |
| to create a numeric value that stands for the degree | | | | injury. |
| to which the TBI patient is in a coma state (in which | | | | The Rancho Los Amigos Scale is as follows: |
| "coma" is defined as unable to obey commands, | | | | * Level I - No Response - Patient cannot respond to |
| speak coherently or open the eyes). | | | | external stimuli including sound, touch, or speech; |
| The Glasgow scale is as follows: | | | | * Level II - Generalized Response - Patient can |
| Eye Response (E): | | | | respond to stimuli only inconsistently and may open |
| * Eyes open spontaneously (4); | | | | the eyes without appearing to see or focus; |
| * Eyes open to speech [not to be confused with a | | | | * Level III - Localized Response - Patient may |
| sleeping person awakening, which rates a 4 on the | | | | respond to simple commands; patient responds |
| scale] (3); | | | | inconsistently to external stimuli; |
| * Eyes open to pain [pain is administered by applying | | | | * Level IV - Confused, Agitated - Patient is in a state |
| pressure to the fingernail of the victim, with other | | | | of agitation and exhibits excitable behaviors that may |
| measures implemented if there is no response] (2); | | | | range to the abusive or aggressive; |
| * Eyes do not open (1). | | | | * Level V - Confused, Inappropriate, Non-Agitated - |
| Verbal Response (V): | | | | Patient is unable to process new information and may |
| * Oriented - patient is able to respond to queries | | | | display verbally inappropriate behavior; patient can |
| about date, time, place, and his name and age (5); | | | | follow commands and appears alert; |
| * Confused - patient is somewhat disoriented, though | | | | * Level VI - Confused Appropriate - Patient has |
| he or she can respond coherently when questioned | | | | some self-awareness and can be taught simple tasks; |
| (4); | | | | patient's attention and memory span are improving; |
| * Inappropriate words - patient cannot engage in | | | | * Level VII - Automatic Appropriate - Patient no |
| conversation and forms sentences of random words | | | | longer seems confused, but carries out tasks in a |
| or utters individual words at random (3); | | | | "robotic" fashion; patient appears normal but has poor |
| * Incomprensible sounds - patient makes moaning | | | | judgment and needs guidance; |
| sounds or other verbalizations, but does not form | | | | * Level VIII - Purposeful Appropriate - Patient is |
| words (2); | | | | oriented as to time and place and exhibits alertness |
| * No verbal response (1). | | | | and functionality. |
| Motor Response (M): | | | | If You've Been Affected By Traumatic Brain Injury |
| * Obeys commands - patient can complete simple | | | | If you or a loved one has been in a coma or has |
| tasks when asked (6); | | | | experienced the effects of TBI, consider contacting |
| * Localizes to pain - patient can try to prevent or | | | | an experienced brain injury attorney. Your traumatic |
| change pain administered by a doctor (5); | | | | brain injury lawyer may be able to obtain |
| * Withdraws from pain - patient flexes, flinches or | | | | compensation for your injury including paying for |
| pulls the body away when pain is administered (4); | | | | medical bills, surgeries and therapies, covering the |
| * Flexion to pain (3); | | | | costs of lost wages and future medical care. |
| * Extension to pain (2); | | | | |