Related Experiment Video
Updated: Jul 7, 2026
SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
Paediatric coma scales
Fenella J Kirkham1, Charles R J C Newton, William Whitehouse
1Neurosciences Unit, Institute of Child Health, University College London, London, UK. f.kirkham@ich.ucl.ac.uk
Insights
Assessing paediatric coma requires reliable scales for accurate consciousness depth measurement. The modified child
Area of Science:
- Pediatric Neurology
- Neuroscience
- Critical Care Medicine
Background:
- Coma in children presents significant mortality and morbidity risks.
- Early recognition of deterioration is crucial in pediatric practice.
- Existing coma scales are used in clinical settings for adults and children.
Purpose of the Study:
- To review the historical development of coma scales.
- To discuss the rationale for recommending specific scales in pediatric practice.
- To highlight the importance of scale reliability in clinical assessments.
Main Methods:
- Review of recent literature on coma scale development.
- Analysis of the criteria for scale reliability (inter-observer and test-retest).
- Examination of the British Paediatric Neurology Association's recommendation.
Main Results:
- Several coma scales exist for assessing consciousness depth.
- Scale reliability is essential for consistent patient assessment across different settings and personnel.
- The modified child's Glasgow coma scale (CGCS) is recommended by the British Paediatric Neurology Association for UK use.
Conclusions:
- Reliable coma scales are vital for accurate pediatric patient assessment.
- The modified child's Glasgow coma scale (CGCS) is a recommended tool for UK pediatric practice.
- Emphasis is placed on the need for consistent and dependable consciousness depth assessments.
Abstract:
Traumatic and non-traumatic coma is a common problem in paediatric practice with high mortality and morbidity. Early recognition of the potential for catastrophic deterioration in a variety of settings is essential and several coma scales have been developed for recording depth of consciousness that are widely used in clinical practice in adults and children. Prediction of outcome is probably less important, as this may be able to be modified by appropriate emergency treatment, and other clinical and neurophysiological criteria allow a greater degree of precision. The scales should be reliable, i.e. with little variation between observers and in test-retest by one observer, since this promotes confidence in the assessments at different time points and by different examiners. This is particularly important when the patient is being assessed by personnel dealing with adults as well as children, discussed on the telephone, handed over at shift change, or transferred between units or hospitals. The British Paediatric Neurology Association has recommended one of the modified child's Glasgow coma scales (CGCS) for use in the UK. This review looks at the recent history of the development of coma scales and the rationale for recommending the CGCS.
