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The Glasgow Coma Scale Made Easy
Peter3 years ago
GLASGOW COMA SCALE
Remember:
4, 5 & 6 for Eyes, Mouth & Movement
EYE Opening (EYES Has 4 letters; carries 4 points)
1. Never open their eyes (Score 1)
2. Open to only Pain/Pressure (Score 2)
3. Open to only Sound (Score 3)
4. Opens On impulse (Score 4)
VERBAL Response (MOUTH has 5 letters; carries 5 points)
1. No Sound made to pain (Score 1)
2. Makes sound to pain (Score 2)
3. Says incomprehensible words (Score 3)
4. Speaks fluently but is disoriented (Score 4)
5. Person is oriented to Person, Place and Time (Score 5)
MOTOR Response (MOTORS has 6 letters; carries 6 points)
1. No movement (Score 1)
2. Decerebrate posture (Score 2)
3. Decorticate posture (Score 3)
4. Flexes/Withdraws from pain (Score 4)
5. Localizes to pain (Score 5)
6. Follows command (Score 6)
Definition
The Glasgow coma scale (GCS) is a universally accepted clinical test used to measure and report the consciousness level of a person.
GCS score also helps to determine the progression of a patient’s condition.
Systems used to determine score
Three different systems are measured and summed to determine consciousness level on the Glasgow Coma Scale.
1. Eye Response
2. Verbal Response
3. Motor Response
The lower the score, the lower the patient's conscious state.
A. The lowest score for each category is 1.
The lowest possible GCS score after summing the scores from all three categories is three (3)
B. The highest possible score is Fifteen (15)
Classification of the GCS
1. Severe state
a. Less or Equal to Eight (< 8)
2. Moderate state
a. Within numbers Nine to Twelve (9 – 12)
3. Minor state
a. Any number greater than or equal to thirteen (< 13)
Details and Significance of each System to the Scale
EYE OPENING
1. Did the patient ever open their eyes?
2. To what did the patient open their eyes?
3. Scoring Eye opening
a. Nothing/Never open their eyes (Score 1)
b. Pressure (Score 2)
c. Sound (Score 3)
d. Spontaneous/On impulse (Score 4)
VERBAL RESPONSE
1. Did the patient make any sound?
2. He couldn’t speak but he made some sound
3. He could speak
a. If he could speak, was he Oriented to Person, Place and Time?
b. He could speak but he wasn’t oriented?
c. He said some words but you couldn’t make out what he was saying (Incomprehensible words)
4. Scoring Verbal response
a. No sound to pain (Score 1)
b. Sound only to pain (Score 2)
c. Incomprehensible words (Score 3)
d. Comprehensible words but patient isn’t oriented (Score 4)
e. Patient is Oriented to Person, Place and Time (Score 5)
MOTOR RESPONSE
1. The patient makes No movement when pressure is applied to cause pain.
2. The patient is in DecErebrate position (i.e. Abnormal Extension).
a. Due to severe brain damage
b. Extremities are held straight out (with clenched fists)
c. Toes are pointed downwards
d. Neck is extended with the head backwards
3. The Patient is in Decorticate position (i.e. Abnormal flexion of upper extremity)
a. Due to severe brain damage
b. Arms are flexed at the elbows (with clenched fists)
c. Toes are pointed downwards
d. Neck is flexed with the head forward
4. Patient pulls away when pressure is applied (Normal flexion/Withdrawal from pain)
5. Patient tries to stop you or pulls extremity towards the point of pain when you apply pressure (Localizes pain)
6. Patient follows command, he is able to make movements.
7. Scoring MOTOR response
a. No movement (Score 1)
b. Decerebrate posture (Score 2)
c. Decorticate posture (Score 3)
d. Flexes/Withdraws from pain (Score 4)
e. Localizes pain (Score 5)
f. Follows command (Score 6)
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