Assessment of responsiveness in head injury patients. The Glasgow Coma Scale and some comments on alternative methods.

The last twelve years history of coma scaling, i.e. reaction level scaling is reviewed. Examples are given of different Glasgow Coma Scale sum scores. The common use of these "sum scores", aggregations of various features, may give an impression of corresponding conscious levels with different functions tested. A more direct approach with mention of varied responses in a reaction level scale may be more reliable and this is also possible to use in a neurological observation chart at bedside.