About pGCSThis is the modified version of the Glasgow Coma Scale (adapted for use in pediatric patients younger than 2 years old). Result interpretationThe pGCS is scored in a similar manner to the adult version, with results ranging from 3 to 15, where 3 indicates coma or exitus and 15 indicates a patient that is fully aware and awake.Any score below 12 is indicative of moderate to severe head injury.
Patients who score below 8 are likely to require intubation and those scoring below 6 should also have the intracranial pressure monitored.When the score is reported, it is sometimes broken down per components to communicate more information. For example, a score of 11 could be followed by E4V4M3.This describes a patient that may suffer from moderate to severe head trauma, who is not likely to require intubation, with spontaneous eye opening, with cry that is consolable and with abnormal flexion to pain for an infant (decorticate response). Strengths and limitationsThe original study dates from 1986 when the GCS was adapted for pediatric use by.Subsequent validation studies have been performed on cohorts of patients with blunt head trauma or other types of infant trauma.The pGCS was found to be as efficient in evaluating and tracking a patient’s mental status in its target population as the standard adult version.The scale was found to have relatively lower accuracy in identifying traumatic brain injury on CT than the standard version.
Also, in the original study, only 36% of subjects have been examined by CT, thus not knowing for sure whether all patients ruled out from traumatic brain injury by the scale, did not have any traumatic findings.Another limitation is that given by the age 2 threshold, thus the scale is only addressed to preverbal pediatric populations. Original sourceJames HE. 1986; 15(1):16-22. ValidationBorgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN).
Acad Emerg Med. 2016; 23(8):878-84. Other references1. Reilly PL, Simpson DA, Sprod R, Thomas L.
Childs Nerv Syst. 1988; 4(1):30-3.2. Holmes JF, Palchak MJ, MacFarlane T, Kuppermann N. Acad Emerg Med. 2005; 12(9):814-9.3.
Pediatric Glasgow Coma Scale Pdf Pages
Simpson DA, Cockington RA, Hanieh A, Raftos J, Reilly PL. Childs Nerv Syst. 1991; 7(4):183-90.