Is it possible to define a general "conscious level"?

The difficulties in defining a general conscious level are discussed as exemplified by Glasgow Coma Scale and Reaction Level Scale, a new scale recommended by Swedish neurosurgeons. Precise definitions of stimuli and of responses are needed since several studies have shown ambiguity of assessment within the same patient. Some of the difficulties arising from summing up and grouping levels of the Glasgow Coma Scores are discussed and as a consequence a new level for defining coma with a better reliability is proposed. We also briefly discuss the difficulty when to stop assessing conscious level.