If you have a friend or family member hospitalized due to an auto accident, you may have some difficulty understanding the scores and scales used by the hospital staff.

I have included here some of the common tools used by the medical professionals.

If your friend/family member is in a coma a tool called Glascow Coma Scale is most likely used to evaluate the depth of the coma or to measure the process of coming out of a coma.

Using the Glasgow Coma Scale:

Eye Opening	Spontaneous 4 To verbal command 3 To pain 2 No response 1
Motor Response	Obeys commands 6 To painful stimuli     Localizes pain; pushes stimulus away 5     Flexes and withdraws 4     Abnormal flexion 3     Extension 2     No response 1
Verbal response (Arouse patient with painful stimuli, if necessary)	Oriented and converses 5 Disoriented and converses 4 Uses inappropriate words 3 Makes incomprehensible sounds 2 No response 1
Total: 3 to 15

The person evaluating the patient gives a number to each of the three areas. Then the three numbers are added to give the final figure.

Ranchos Los Amigos Scale:

Level I: No response to pain, touch sound or sight

Level II: Generalized reflex response to painful stimuli.

Level III: Localized Response. Blinks to strong light, turns toward or away from sound, responds to physical discomfort, inconsistent response to commands.

Level IV: Confused/Agitated. Alert, very active, aggressive or bizarre behaviors, non-purposeful motor activities, short attention span.

Level V: Confused, Inappropriate Non-Agitated. Gross attention to environment, highly distractible, requires continual redirection, difficulty learning new tasks, agitated by too much stimulation, inappropriate social interactions.

Level VI: Confused, Appropriate. Inconsistent orientation to time and place, retention span/recent memory impaired, follows simple directions, begins to recall past, goal-directed behavior with assistance.

Level VII: Automatic, Appropriate. Performs daily routine in a robot-like manner, skills deteriorate in an unfamiliar environment, unrealistic planning.

Level VIII: Purposeful, Appropriate. Stand-by assistance. Consistently oriented to person, place and time, over/underestimates abilities, irritable, self-centered, acknowledges other's feelings with minimal assistance, low frustration tolerance.

Level IX: Purposeful, Appropriate. Stand-by assistance on request. Completes familiar tasks independently, independently shifts between tasks, self-monitors and anticipates problems, uses assistive memory devices to recall daily schedule.

Level X: Purposeful, Appropriate. Modified Independence. Handles multiple tasks simultaneously, independently initiates and carries unfamiliar routines, anticipates impact of independently thinks about consequences of decisions, social interaction behavior is consistently appropriate.

The appropriate level is determined by the level closest to your family members' abilities. Sometimes the health team uses two level numbers to show that a patient is in between two levels.

Here are some definitions that may be helpful.