Neurosurgeons at the Adelaide Children’s Hospital, King William Street, North Adelaide, SA 5006, Australia have used a paediatric version of the Glasgow Coma Scale since 1977 for assessing conscious level in infants and young children.
Neurosurgeons at the Adelaide Children’s Hospital, King William Street, North Adelaide, SA 5006, Australia have used a paediatric version of the Glasgow Coma Scale since 1977 for assessing conscious level in infants and young children. For the best verbal response, during the first 6 months the normally conscious infant is expected to cry or grunt spontaneously or when disturbed and the expected normal score is 2. Between 6 and 12 months, the normal infant babbles and begins to vocalize and scores 3. After 12 months, words are expected with a score of 4. Orientation by 5 years of age gives a score of 5. The normal aggregate scores at different ages are as follows: birth-6 mth: 9; 6-12 mth: 11; 12-24 mth: 12; 2-5 yr: 13; over 5 yr:14. A disadvantage of the scale is the reduced sensitivity, especially in the neonate. [1]
COMMENT: In an editorial comment, Dr AJ Raimondi corroborates the need for children’s and infant’s coma scales as substitutes for the well known Glasgow scale suitable mainly for adults. He favors an 11-point scale for infants, which incorporates ocular responses (ranging from normal pursuit to fixed pupils), verbal responses (ranging from crying to apnea), and motor responses (from flexion/ extension to flaccidity). A uniformly tested and accepted coma scale for infants and children would be advantageous. Coma scores as low as 3-4 carry the same prediction of poor outcome at any age; coma scores of 5-8 may carry a less serious significance in young children than in adults.
ReillyPLSimpsonDASprodRThomasLAssessing the conscious level in infants and young children: a paediatric version of the Glasgow Coma ScaleChilds Nerv Syst1988Feb413033135935