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Related Subjects: |Assessing Coma and Management |Glasgow Coma scale |Acute Poisoning |Trauma: Traumatic Brain Head Injury (TBI)
GCS is a very useful score. Changes may be more important than actual values. I always encourage doctors to say what patients can do rather than discuss just numbers. It gives us a useful framework to discuss comatose patients. Be sensible, a dysphasic patient perhaps due to a stroke affecting speech areas may have no speech but should not really be graded as a 1 without explicitly saying he/she is dysphasic. Patients at GCS of 8 and below tend to be intubated to protect the airway and prevent hypoxia and aspiration pneumonitis. If GCS is reduced always seek senior support. See Coma
Note:If intubated or aphasic, the verbal component is not assessable; this should be noted and scored as "V-NT" (Verbal: Not testable).
Category | Response | Score |
---|---|---|
Eye Opening (E) | Spontaneous - Opens eyes spontaneously | 4 |
To Sound - Opens eyes in response to speech | 3 | |
To Pressure - Opens eyes in response to painful stimulus | 2 | |
None - No eye opening | 1 | |
Verbal Response (V) | Oriented - Speaks coherently and is oriented to time, place, and person | 5 |
Confused - Disoriented, but able to speak coherently | 4 | |
Words - Inappropriate words or phrases, no conversational exchange | 3 | |
Sounds - Incomprehensible sounds, no words | 2 | |
None - No verbal response | 1 | |
Motor Response (M) | Obeys Commands - Performs simple tasks when asked | 6 |
Localizes Pain - Purposeful movement towards painful stimulus | 5 | |
Normal Flexion - Flexes arm at the elbow in response to pain (withdrawal response) | 4 | |
Abnormal Flexion - Decorticate posturing (abnormal flexion) | 3 | |
Extension - Decerebrate posturing (extension) | 2 | |
None - No motor response | 1 |
The Glasgow Coma Scale (GCS) is commonly used in emergency and critical care settings to assess and monitor the level of consciousness in patients with acute brain injuries. It is a key tool in guiding treatment decisions and predicting outcomes in head trauma cases.
Explanation: