The Glasgow Coma Scale at 50
This year is the 50th anniversary of the invention of the world's most-used clinical tool for assessing and treating brain injuries.
An exemplar of the University's world-changing research, the Glasgow Coma Scale (GCS) was developed in 1974 by two internationally recognised neurosurgeons, Emeritus Professor Sir Graham Teasdale and Professor Bryan Jennett (1926–2008).
Developed as a way to communicate about the level of consciousness of patients with an acute brain injury, the GCS provides a practical and rapid assessment of the conscious state of a person suspected of having recently experienced injury to the brain.
Since its conception, the GCS has become a globally recognised method used by clinicians worldwide to help decision making and monitor trends in patient responsiveness. It is an integral part of clinical practice and research around the globe – featuring in more than 40,000 articles across the field of medicine and also being included in around 100 global clinical guidelines.
Speaking to Avenue, Professor Teasdale explains that, until the GCS, "the idea of describing a patient’s conscious level – an abstract concept of how the brain is working – had been around for a long time, but there were a lot of different scales around and there was no consistency. This impacted decision making and communication, ultimately affecting patient care."
What the GCS did, according to Teasdale, was provide a similar scale that anyone, anywhere, could use to communicate effectively and consistently about patients in both clinical care and in research studies and articles.
Teasdale says the key factor of the scale's success was the involvement of nursing staff: "Having discussions with them on the ward, trying different approaches and seeing what worked. The nurses provided input and made it clear that it was an important part of their work – and they wanted to be able to do it well and usefully. So, I took a lot of account of what nurses said, and I think that’s probably been one of the most important things that has sustained it these past 50 years."
The GCS is now widely used throughout the world in first aid, in the care of acute medical, septic and trauma patients, and is a key element of research into improving their management. The scale has been translated into 45 languages and the website supporting education in the application of the scale (see right) has received more than a million visits.