Head Injury Center

The Rancho Los Amigo Scale is a useful tool which is designed for the assessment of recovery in patients suffering from a traumatic brain injury. The changes in the behavior and cognitive functioning of the brain during the recovery from head injury can be described using the Rancho scale. There are 10 levels involved in the scale which describe the status of recovery in a TBI patient. Each level points out the visible progress in recovery but it cannot be used to determine whether the patient has a potential to recover further. It is used only as a description tool and not for assessing anything else. There are some cases where the patient shows progress in recovery from TBI but may not go beyond a specific level on the scale.

There are 8 levels of recovery on the original Rancho scale and 10 on the revised Rancho Scale. The last three levels of the revised scale are similar to each other except subtle changes in some aspects of the patient’s behavior. The least reading on the scale is level 1 which indicates that there is no change in the behavior and cognition and the highest reading is level 10 which indicates a substantial recovery from TBI. The Rancho Scale assesses cognitive status in general and does not analyze any particular cognitive function. The results of testing a patient on the Rancho Scale can assist the doctors or other medical professionals to devise further plans for the treatment of the patient. Although it is a medical test, the cooperation of the patient is not required to conduct this test. The results of the test are calculated on the basis of mere observation of the responding ability of TBI patients to external stimuli.

The Levels of Rancho Scale

Level I – No responsiveness to stimuli.
Level II – The patient responds in a general manner to stimulus like a reflex action to pain stimuli.
Level III – A localized response like withdrawal of a body part when it pains or blinking of the eyes on exposure to light.
Level IV – The patient responds to external stimulus in a confused and agitated state of mind.
Level V – The patient is confused and responds inappropriately but without agitation.
Level VI – Appropriate response to external stimuli but still the patient has a confused mindset.
Level VII – The response of the patient is automatic, consistent and appropriate.
Level VIII – The patient responds purposefully, appropriately and is aware of the surroundings but can be easily angered.
Level IX – The response of the patient is on purpose and is appropriate. Also, the patient can tolerate frustration up to an extent.
Level X – The patient is totally aware of everything around him and can independently respond to external stimuli.

Credit
Rancho Los Amigos Scale