From the Research
The Rancho Los Amigos Level of Consciousness Scale (RLAS) should be used to assess patients with traumatic brain injury, particularly those in post-coma states or undergoing rehabilitation, as it provides a comprehensive evaluation of cognitive functioning and behavioral responses. The criteria for using this scale includes patients who have experienced traumatic brain injury, are in post-coma states, or are undergoing rehabilitation after brain injury. The scale is most appropriate when healthcare providers need to monitor cognitive recovery over time, as it categorizes patients into eight levels ranging from no response (Level I) to purposeful and appropriate responses (Level VIII) 1. Some studies suggest that the Glasgow Coma Scale (GCS) is still widely used to describe and assess coma, but its prognostic value regarding the outcome after a traumatic brain injury still lacks evidence 2. However, the RLAS is particularly valuable because it focuses on behavioral responses rather than just arousal, making it more comprehensive than simpler scales like the GCS 3. For proper implementation, assessments should be performed by trained healthcare professionals who understand the nuances of each level and can accurately document changes in cognitive function over time. Regular reassessments are necessary to track progress, typically conducted daily in acute settings and less frequently during long-term rehabilitation. It is also important to note that classification of a traumatic brain injury should not be based solely on the GCS, but also consider other important clinical signs such as pupil reactivity to light and computer tomogram (CT) findings 4. Overall, the RLAS is a useful tool for assessing and tracking cognitive functioning in patients with traumatic brain injury, and its use should be considered in conjunction with other clinical assessments and evaluations. Key points to consider when using the RLAS include:
- The scale should be used to assess patients with traumatic brain injury, particularly those in post-coma states or undergoing rehabilitation
- The scale categorizes patients into eight levels ranging from no response (Level I) to purposeful and appropriate responses (Level VIII)
- Assessments should be performed by trained healthcare professionals who understand the nuances of each level
- Regular reassessments are necessary to track progress
- The RLAS should be used in conjunction with other clinical assessments and evaluations, such as the GCS and CT findings.