Medical records
Glasgow Coma Scale (GCS)
The Glasgow Coma Scale is the standard 3-to-15 score for level of consciousness after head trauma, built from eye-opening, verbal, and motor responses — and one of the first numbers a legal reader should find in any brain-injury file.
Three components sum to the score: eye opening (1–4), verbal response (1–5), motor response (1–6). A fully alert patient is 15; deep unresponsiveness is 3. Conventional severity bands: 13–15 mild, 9–12 moderate, 8 and below severe (“GCS 8, intubate”). Charts often record the components — “E4V5M6” — not just the total, and EMS run sheets typically capture the first score at the scene.
Why it matters for legal readers
In traumatic brain injury litigation, GCS is where the severity fight starts. A scene GCS of 14–15 anchors the defense framing of “mild TBI” — but the score measures consciousness at a moment, not outcome, and mild-by-GCS injuries can carry lasting cognitive symptoms; plaintiff teams pair early scores with later neuropsychological findings rather than fighting the number. Trajectory matters more than any single value: scene, ER arrival, and serial scores tell a story a lone number can’t.
Read carefully for confounds the chart itself may note — intoxication, sedation, intubation (which caps the verbal score, often charted as “V1T”) — each a reason a score under- or overstates the injury.
In the fact record
GCS values are scattered across EMS sheets, ER notes, and flow charts. Extracted onto one timeline with citations, the trajectory — and any suspicious jumps between documents — reads at a glance.