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Effectiveness of a Glasgow Coma Scale Instructional Video for EMS Providers

  • Peter L. Lane (a1), Amado Alejandro Báez (a2), Thomas Brabson (a1), David D. Burmeister (a3) and John J. Kelly (a1)...



The Glasgow Coma Scale (GCS) is the standard measure used to quantify the level of consciousness of patients who have sustained head injuries. Rapid and accurate GCS scoring is essential.


To evaluate the effectiveness of a GCS teaching video shown to prehospital emergency medical services (EMS) providers.


Participants and setting—United States, Mid-Atlantic region EMS providers. Intervention—Each participant scored all of the three components of the GCS for each of four scenarios provided before and after viewing a video-tape recording containing four scenarios. Design—Before-and-after single (Phase I) and parallel Cohort (Phase II). Analysis— Proportions of correct scores were compared using chi-square, and relative risk was calculated to measure the strength of the association.


75 participants were included in Phase I. In Phase II, 46 participants participated in a parallel cohort design: 20 used GCS reference cards and 26 did not use the cards. Before observing the instructional video, only 14.7% score all of the scenarios correctly, where as after viewing the video, 64.0% scored the scenarios results were observed after viewing the video for those who used the GCS cards (p = 0.001; RR = 2.0; 95% CI = 1.29 to 3.10) than for those not using the cards (p <0.0001; RR = 10.0; 95% CI = 2.60 to 38.50).


Post-video viewing scores were better than those observed before the video presentation. Ongoing evaluations include analysis of longterm skill retention and scoring accuracy in the clinical environment.


Corresponding author

Department of Emergency Medicine, Albert Einstein Medical Center, Korman B-6, 5501 Old York Road, Philadelphia, PA 19141 USA, E-mail:


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