Makindo Medical Notes

Related Subjects: |Assessing Coma and Management |Glasgow Coma scale |Acute Poisoning |Trauma: Traumatic Brain Head Injury (TBI)

🧠 The Glasgow Coma Scale (GCS) is a vital score for assessing consciousness. 🚨 Remember: *changes* in GCS are often more important than the absolute number. 💡 Always describe what the patient can/can’t do rather than quoting just numbers. ⚠️ A dysphasic patient may score "1" on verbal response, but you should clarify "V1 (dysphasic)" rather than implying complete unresponsiveness. 🔒 Patients with GCS ≤ 8 are generally intubated to protect the airway and prevent aspiration pneumonitis. 👩‍⚕️ If GCS is reduced ➝ escalate to senior support immediately.

📖 Introduction

• The GCS is used to assess consciousness in head injury 💥, coma, and other acute brain disorders.
• It evaluates 3 domains: 👀 Eye-opening, 🗣️ Verbal response, ✋ Motor response.
• Total scores range from 3 (deep coma) ➝ 15 (fully alert).

📊 Scoring Overview

• Total GCS = E + V + M
• Severe: 3–8 ❌
• Moderate: 9–12 ⚠️
• Mild: 13–15 ✅

🔍 How to Perform

• 👀 Eye response ➝ spontaneous? to voice? to pain?
• 🗣️ Verbal ➝ oriented? confused? incomprehensible?
• ✋ Motor ➝ obeys? localises? flexion/extension?

Note: If intubated, tracheostomised, or aphasic ➝ record as V-NT (not testable).

📋 GCS Table

📌 Interpretation

• 13–15: Mild head injury 😊
• 9–12: Moderate injury ⚠️
• 3–8: Severe coma ❌ ➝ airway protection needed

🏥 Usage

Used in ED, ITU, and neurology/stroke wards to assess consciousness. Helps guide airway management, neurosurgical referral, and prognosis in traumatic brain injury and other comatose states. Always compare with previous scores to identify deterioration. 📉

🖼️ Visual Aids

📄 Download full GCS chart