The Glasgow Coma Scale: time for change.

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.