PATIENTS WITH GLASGOW COMA SCALE SCORE-3, SCORE-4, SCORE-5 AFTER GUNSHOT WOUNDS TO THE BRAIN

A large proportion of patients who arrive at hospitals after gunshot w ounds to the head have GCS scores of 3, 4, or 5, indicating a very sev ere brain injury. Death rates for these patients are high, and those w ho survive often have devastating neurological deficits. Several progn ostic indicators have been identified that may identify patients who m ay be salvageable; however, most of these patients will do poorly. The refore, there must be societal decisions about how to balance the righ ts of patients who expect care and the responsibility of society to pr ovide this care against the obligations of patients not to be unreason able about their demands, and the need for society to allocate limited resources in the most fair way, and thus, who should be treated.