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Jun 12, 2023 · The Glasgow Coma Scale (GCS) is used to objectively describe the extent of impaired consciousness in all types of acute medical and trauma patients. The scale assesses patients according to three aspects of responsiveness: eye-opening, motor, and verbal responses.
- Shobhit Jain, Lindsay M. Iverson
- 2023/06/12
- 2019
- Introduction
- Eye-Opening
- Verbal Response
- Motor Response
- Summary
- References
The Glasgow Coma Scale(GCS) allows healthcare professionals to consistently evaluate the level of consciousness of a patient. It is commonly used in the context of head trauma, but it is also useful in a wide variety of other non-trauma related settings. Regular assessment of a patient’s GCS can identify early signs of deterioration. There are thre...
Eyes opening spontaneously
To assess eye response, initially observe if the patient is opening their eyes spontaneously. If the patient isopening their eyes spontaneously, your assessment of this behaviour is complete, with the patient scoring4 points. You would then move on to assessing verbal response, as shown in the next section. If however, the patient is not opening their eyes spontaneously, you need to work through the following steps until a response is obtained.
Eyes opening to sound
If the patient doesn’t open their eyes spontaneously, you need to speak to the patient “Hey Mrs Smith, are you ok?” If the patient’s eyes open in response to thesound of your voice, they score 3 points.
Eyes opening to pain
If the patient doesn’t open their eyes in response to sound, you need to move on to assessingeye-opening to pain. There are different ways of assessing response to pain, but the most common are: 1. Applying pressure to one of the patient’s fingertips 2. Squeezing one of the patient’s trapezius muscles(known as a trapezius squeeze) 3. Applying pressure to the patient’s supraorbital notch If the patient’s eyes open in response to a painful stimulus, they score 2 points.
Orientated response
If the patient is able to answer your questions appropriately, the assessment of verbal response is complete, with the patient scoring 5 points.
Confused conversation
If the patient is able to reply, but their responses don’t seem quite right (e.g. they don’t know where they are, or what the date is), this would be classed as confused conversation and they would score 4 points. Sometimes confusion can be quite subtle, so pay close attentionto their responses.
Inappropriate words
If the patient responds with seemingly random words that are completely unrelated to the question you asked, this would be classed as inappropriate words and they would score 3 points.
Obeys commands
Ask the patient to perform a two-part request (e.g. “Lift your right arm off the bed and make a fist.”). If they are able to follow this command correctly, they would score 6 pointsand the assessment would be over.
Localises to pain
This assessment involves applying a painful stimulus and observing the patient for a response. There are different ways of assessing response to pain, but the most common are: 1. Squeezing one of the patient’s trapezius muscles(known as a trapezius squeeze) 2. Applying pressure to the patient’s supraorbital notch If the patient makes attempts to reach towards the site at which you are applying a painful stimulus (e.g. head, neck) and brings their hand above their clavicle, this would be class...
Withdraws to pain
This is another possible response to a painful stimulus, which involves the patient trying to withdraw from the pain(e.g. the patient tries to pull their arm away from you when applying a painful stimulus to their fingertip). This response is also referred to as a “normal flexion response” as the patient typically flexes their arm rapidly at their elbow to move away from the painful stimulus. It differs from the “abnormal flexion response to pain” shown below due to the absence of the other f...
Once you have assessed eye-opening, verbal response and motor response you add the scores together to calculate the patient’s GCS. The GCS should be documentedshowing the score for each individual behaviour tested: 1. GCS 15 [E4, V5, M6]
Teasdale G, Jennett B; Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974 Jul 13 2(7872):81-4. Available from: [LINK].Royal College of Physicians and Surgeons of Glasgow. GLASGOW COMA SCALE: Do it this way. Available from: [HERE].The Glasgow Coma Scale [1] (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury. The GCS assesses a person based on their ability to perform eye movements, speak, and move their body.
What is the Glasgow Coma Scale? The Scale was described in 1974 by Graham Teasdale and Bryan Jennett (Assessment of coma and impaired consciousness. A practical scale. Lancet 1974; 2:81-4.) as a way to communicate about the level of consciousness of patients with an acute brain injury.
- Graham.Teasdale@glasgow.ac.uk
May 2, 2019 · The Glasgow coma scale (GCS) is a tool used to assess and calculate a patient’s level of consciousness. It was developed more than 40 years ago by two neurosurgeons in Glasgow and is widely applied today.1 The GCS uses a triple criteria scoring system: best eye opening (maximum 4 points), best verbal response (maximum 5 points), and best ...
- Rhea Mehta, GP trainee, Krishna Chinthapalli, Krishna Chinthapalli, consultant neurologist
- 2019
For factors Interfering with communication, ability to respond and other injuries. Sound: spoken or shouted request. Physical: Pressure on nger tip, trapezius or supraorbital notch.
The Glasgow Coma Scale (GCS) estimates impaired consciousness and coma severity based on response to defined stimuli including Eye, Verbal, and Motor criteria.
