Ranchos Los Amigos Scale

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Synonyms
Ranchos Los Amigos scale, Rancho Los Amigos Levels of Cognitive Functioning Scale, LOCF, RLAS

The Ranchos Los Amigos Scale is a commonly used classification system for impairments following a traumatic brain injury and is divided as follows1:

Level Description
I No response to pain, touch, visual, or auditory stimuli
II Generalized reflex response to pain
III Localized response. Blinks in response to bright light, turns the head toward auditory stimuli, responds to discomfort. Inconsistent response to commands.
IV Confused and agitated. Patient is awake and very active, agitated, aggressive, or exhibiting bizarre behavior. Spontaneous movement is present but is not purposeful. Very short attention span.
V Confused and not agitated. Attends to the surroundings. Easily distracted. Difficulty learning new tasks. Becomes agitated with too much stimulation. Social interaction is possible, but with inappropriate verbal responses.
VI Confused, appropriate. Inconsistently oriented to time and place. Memory span and short-term memory are impaired. Begins to remember past events. Follows simple commands. Goal-directed behavior with assistance.
VII Automatic, appropriate. Performs daily routines in familiar environments in a non-confused but automatic manner.
VIII Purposeful, appropriate

References

    1. Outcome Assessment. In: Greenberg M, ed. Handbook of Neurosurgery. 9th Edition. Thieme; 2019. ↩ ↩

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    Edit · Alaric Steinmetz · (+10 −10)
    • Text changed: “The Ranchos Los Amigos Scale is a frequently used classification system for impairments after a [traumatic brain injury](\/lexikon\/schaedelhirntrauma-sht) and is classified as follows[^1]:”“The Ranchos Los Amigos Scale is a commonly used classification system for impairments following a [traumatic brain injury](\/lexikon\/schaedelhirntrauma-sht) and is divided as follows[^1]:”
    • Text changed: “| Level | Description | | ------|-------------| | I | No response to pain, touch, visual, or auditory stimuli | | II | Generalized reflex response to pain | | III | Localized response. Blinks in response to bright light, turns the head toward auditory stimuli, and responds to discomfort. Inconsistent response to commands. | | IV | Confused and agitated. Patient is awake and very active, agitated, aggressive, or exhibiting bizarre behavior. Spontaneous movement is present but serves no purpose. Very short attention span. | | V | Confused and not agitated. Attentive to the environment. Easily distracted. Difficulty learning new tasks. Becomes agitated with excessive stimulation. Social interaction is possible, but with inappropriate verbal responses. | | VI | Confused but appropriate. Inconsistent orientation to time and place. Impaired memory span and short-term memory. Begins to recall past events. Follows simple commands. Goal-directed behavior with assistance. | | VII | Automatic and appropriate. Performs daily routines in familiar environments in a nonconfused but automatic manner. | Abilities deteriorate in an unfamiliar environment. No realistic ability to plan for future events. | VIII | Purposeful and appropriate |”“| Level | Description | | ------|-------------| | I | No response to pain, touch, visual, or auditory stimuli | | II | Generalized reflex response to pain | | III | Localized response. Blinks in response to bright light, turns the head toward auditory stimuli, responds to discomfort. Inconsistent response to commands. | | IV | Confused and agitated. Patient is awake and very active, agitated, aggressive, or exhibiting bizarre behavior. Spontaneous movement is present but is not purposeful. Very short attention span. | | V | Confused and not agitated. Attends to the surroundings. Easily distracted. Difficulty learning new tasks. Becomes agitated with too much stimulation. Social interaction is possible, but with inappropriate verbal responses. | | VI | Confused, appropriate. Inconsistently oriented to time and place. Memory span and short-term memory are impaired. Begins to remember past events. Follows simple commands. Goal-directed behavior with assistance. | | VII | Automatic, appropriate. Performs daily routines in familiar environments in a non-confused but automatic manner. | Abilities deteriorate in an unfamiliar environment. No realistic ability to plan for future events. | VIII | Purposeful, appropriate |”
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