GLASGOW COMA SCALE:
The Glasgow Coma Scale (GCS) is the standard measure used to quantify level of consciousness in head injured patients.
Widely used in scoring systems and treatment protocols.
Used as a initial assessment tool and for continual re-evaluation of head injured patients
Low score in Glasgow coma scale indicates deteriorating brain function
The GCS is scored between 3 and 15, 3 being the worst(dead), and 15 ( conscious person)the best.
GCS is composed of three parameters :
Best Eye Response (4)
Best Verbal Response (5)
Best Motor Response (6)
A GCS of:
13 or higher correlates with a mild brain injury
9 to 12 is a moderate injury
8 or less a severe brain injury
Best Eye Response (4)
No eye opening =>1
Eye opening to pain =>2
Eye opening to verbal command =>3
Eyes open spontaneously =>4
Best Motor Response (6)
No motor response =>1
Extension to pain=>2
Flexion to pain=>3
Withdrawal from pain=>4
Localizing pain=>5
Obeys Commands=>6
Best Verbal Response (5)
No verbal response =>1
Incomprehensible sounds =>2
Inappropriate words =>3
Confused =>4
Orientated =>5
Total GCS=Motor response + Verbal response + Eye opening
Interpretation brain injury
Severe <9
Moderate 9-12
Minor 13 and above
Note that the phrase ‘GCS of 11’ is essentially meaningless, and it is important to break the figure down into its components, such as E3V3M5 = GCS 11.
Glasgow coma scale are Less than 7 is classified as coma
Glasgow coma scale More than 9 excludes coma
PROS:
Reliably predicts outcomes for diffuse and focal lesions
CONS:
It does not take into account
Focal or lateralizing signs
Diffuse metabolic processes
Intoxication
Exam Question
Eye opening , Motor response, Verbal response are used for gradation of coma in Glasgow coma scale
Glasgow coma scale score for head injury, eye opening seen with painful stimulus, localize pain and inappropriate verbal response is 10
Glasgow coma scale is the best prognostic factor in a case of head injury
According to the Glasgow Coma Scale (GCS), a verbal score of 1 indicates No response
Glasgow Coma Scale score in a conscious person is 15
Glasgow coma scale Ranges from 3 – 15
Glasgow coma scale are Less than 7 is classified as coma
Glasgow coma scale More than 9 excludes coma
Mild head injury is having Glasgow coma scale of 10-15
Low score in Glasgow coma scale indicates deteriorating brain function
According to the Glasgow Coma Scale (GCS), a verbal score of 1 indicates No response
A person with ‘Inappropriate speech’ evaluated by the ‘Glasgow Coma Scale’ will have a verbal score of 3
Glasgow coma scale in death is 3