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Qatar’s Ambulance Paramedics’ evaluation of the conventional versus a revised Glasgow Coma Scale including a pupil score

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conference contribution
submitted on 2024-05-16, 11:17 and posted on 2024-05-23, 12:45 authored by Zynri Jacobs, Herman Schlechter, Johan Niemann, JP Grobbelaar, Hassan Farhat, Padarath Gangaram, Guillaume Alinier


The Glasgow Coma Scale’s (GCS) use has evolved since it was first introduced and is now used to assess a broader range of patients.1 The GCS tool is commonly used by Qatar’s pre-hospital care professionals.2 Proposed changes include the subtraction of the Pupil Reaction Score and simpler assessment termonilogy.3 This is referred to as the GCS-P tool. This study aims to determine whether the changes result in increased ease-of-use and accuracy by qualified paramedics in comparison to the conventional GCS tool.


This quantitative study aimed to recruit a convenience sample of 297 Hamad Medical Corporation Ambulance Service (HMCAS) paramedics who were split into two groups (GCS and GCS-P), each with access to different online questionnaires with two identical brain injury scenario videos to assess (Traumatic Brain Injury (TBI) case and Pedestrian Vehicle Accident (PVA)). For the GCS-P group, an illustration depicting pupil reactivity to light was included. A Chi-square test was conducted to test whether each tested variable was independent between both groups.


The conventional GCS and GCS-P questionnaires were respectively completed by 151 and 150 participants. The GCS group tended to report a score much closer to the expected result for both scenarios than the GCS-P group (Table 1). In Table 2, there is a statistically significant difference in variables 1 and 3 between both groups. Most GCS-P participants (85.6%) responded they would find it easier to directly calculate the pupil score with "0", "-1", and "-2" instead of determining it as a positive number and then subtracting it from the GCS score.


Based on the participants’ GCS scoring results, the GCS-P tool appeared to make participants’ over score the simulated patients’ level of consciousness. The chi-squared test results suggest that more training is needed to increase the familiarity in using the tool.



  • English


Hamad Medical Corporation

Publication Year

  • 2024

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License.

Institution affiliated with

  • Hamad Medical Corporation
  • Ambulance Service - HMC
  • Weill Cornell Medicine - Qatar
  • Ministry of Public Health - State of Qatar

Geographic coverage