Glasgow Coma Scale

Welcome, and thank you for joining me for this video review of the Glasgow Coma Scale.

In this video, we will talk about what the Glasgow Coma Scale is and its components.

Interpreting of Glasgow Coma Scale Scores

The Glasgow Coma Scale got its name from the researchers who developed it at the University of Glasgow.

The Glasgow Coma Scale, or GCS, is a neurological assessment tool that assigns scores to observable patient behaviors to describe a patient’s level of consciousness.

The GCS can help guide trained clinicians such as physicians, nurses, and emergency medical technicians in determining appropriate interventions and identifying trends in a patient’s condition.

The GCS is commonly used for patients with traumatic brain injuries, but can be used to assess consciousness in many situations.

A modified version of the GCS can be used to assess consciousness in children under 5 years of age.

The Glasgow Coma Scale is comprised of three components—eye opening, verbal response, and best motor response.

These are assessed individually before the scores in each category are added together.

The highest scores in each category are given to the most normal assessment findings, and the lowest scores indicate no response.

Before performing the assessment, it is important to check for any factors that might interfere with accuracy, such as language barriers or other injuries.

The first category of assessment is eye opening.

• Spontaneous opening of the eyes is rated a 4.
• A patient whose eyes open in response to a spoken or shouted verbal request is rated a 3.
• If the patient’s eyes do not open in response to sound, physical stimulus is applied in the form of increasing pressure to a fingertip for up to ten seconds, which would be rated a 2.
• No response during this assessment is rated a 1, but the presence of an interfering factor such as swelling of the eyes that prevents opening should be rated as “non-testable,” or “NT.”

The second category of assessment is verbal response.

• A fully oriented and communicative patient receives a score of 5 in this category.
• A patient who is able to express verbal thoughts in phrases or sentences but is not oriented is rated a 4.
• A patient who can speak single word responses is rated a 3,
• and a patient who moans, groans, or uses unintelligible words is rated a 2.
• No audible verbal response without an interfering factor such as a tracheostomy is rated a 1.

The third category of the Glasgow Coma Scale is best motor response.

• A patient who can obey a simple two-step command such as opening his or her mouth and sticking out his tongue receives a score of 6 in this category.
• A central stimulus, such as a trapezius pinch or placing pressure on the supraorbital notch above the eye, may be applied by increasing pressure for up to ten seconds if a patient cannot follow verbal commands. Pressure should not be applied to sites of injury.
• If the patient responds to the central stimulus by bringing one arm across to try to remove the stimulus, it is considered “localizing” and is rated a 5.
• The response of normal flexion of an arm that is not directed toward removing the stimulus is rated a 4.
• Abnormal flexion may appear as a slowed response of bringing the arm toward the body, and is rated a 3.
• If the elbows extend instead of flex in response to the stimulus, the patient receives a 2 in this category.
• No motor response is rated a 1, while patients with interfering factors, such as pharmacologically induced paralysis, should be rated “NT.”

The score for each of the three categories is added together, with a total possible score of up to 15; and the lowest possible score of 3.

Once the score of a patient has been identified, it is important to understand the meaning.

When scoring a patient with a brain injury, they are generally classified as severe, moderate, or mild.

• Severe is 3-8 on the Glasgow Coma Scale
• Moderate is 9-12
• and Mild is 13-15.

The purpose of the scale is to complement, but not replace assessments of other neurological functions.

Thanks for watching and happy studying!

• “Abnormal Flexion.” n.d.