5 However, an inability to test one of the components of the GCS affects the derivation of its sum score. This can be documented in clinical practice as “not testable” and can be compensated for by using motor and eye findings to guide the care of the patient. Loss of a single component occurs most often with the verbal component, 4 usually as a result of intubation. None can be validly assessed in a pharmacologically sedated and paralyzed patient. 2, 3 However, for practical reasons, it is not always possible to test each of the three components of the scale. 1 Its findings support clinical decision-making, communication, and assessment of severity of brain injury in the acute stage as well as likely outcome. T he Glasgow Coma Scale (GCS) has been widely adopted for the assessment of impaired consciousness in patients with a head injury or other types of acute brain damage.
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