Glasgow coma scale: being conscious of mistakes

The Glasgow coma scale (GCS) is the tool most commonly used by paramedics to assess and compare levels of consciousness; the results of this assessment often determine initial and ongoing treatment. Limitations surrounding the use of the GCS in difficult clinical environments and in patients with certain preexisting comorbidities has increased interest in potential alternatives. Despite widespread use of the GCS both in the hospital setting and in out-of-hospital environments, there is limited evidence examining paramedic accuracy when using this assessment tool.

This double-blind, observational, pilot study undertaken in Australia involved 137 (39 % response rate) student paramedics. Students were enrolled on either a Bachelor of Emergency Health (paramedic) (BEH) or Bachelor of Nursing/ Bachelor of Emergency Health (paramedic) (BN/ BEH) degree programme.

A majority of students (n=92) were in either the first or second year of study and 87 were female.

Participants were asked to watch four different simulated scenarios. Each simulation showed a paramedic interviewing an adult patient after which the participant was asked to interpret the conscious state of that patient using the GCS.