What Is the Glasgow Coma Scale?
Glasgow Coma Scale: OverviewThe Glasgow coma scale (GCS) is a neurological scale that is used to assess the level of consciousness of a person. It is most commonly used in clinical settings to assess the depth of coma or the severity of impaired consciousness. The GCS was developed in 1974 by Bryan Jennett and George Teasdale in Glasgow, Scotland, and has since become the most widely used coma assessment scale worldwide.
The GCS involves assessing three different aspects of consciousness: eye opening, verbal response, and motor response. Each of these components is assigned a score, and the total score (out of 15) provides an indication of the patient's level of consciousness.
Components of the Glasgow Coma Scale:
1. Eye Opening: This assesses the patient's ability to open their eyes spontaneously or in response to stimuli. The score for eye opening ranges from 1 to 4:
- 1: No eye opening
- 2: Eyes open in response to pain
- 3: Eyes open in response to verbal stimuli
- 4: Eyes open spontaneously
2. Verbal Response: This assesses the patient's ability to produce comprehensible speech or sounds. The score for verbal response ranges from 1 to 5:
- 1: No verbal response
- 2: Incomprehensible sounds
- 3: Inappropriate words
- 4: Confused conversation
- 5: Coherent conversation
3. Motor Response: This assesses the patient's motor skills and responses to stimuli. The score for motor response ranges from 1 to 6:
- 1: No motor response
- 2: Abnormal posturing
- 3: Flexor response (decorticate posturing)
- 4: Extensor response (decerebrate posturing)
- 5: Obeys commands
- 6: Moves purposefully
The total GCS score is calculated by adding the scores for each component, with a maximum possible score of 15. A score of 15 indicates normal consciousness, while lower scores indicate varying levels of impaired consciousness. Interpretation of the GCS score is done as follows:
- 15 (E4V5M6): Alert and fully awake
- 14-13: Mild brain impairment (confusion, disorientation)
- 11-12: Moderate brain impairment (drowsiness, stupor)
- 8-10: Severe brain impairment (coma)
- 7 or less: Deep coma
The GCS is a valuable tool in assessing consciousness levels in various medical settings, including emergency rooms, intensive care units, and post-operative care. It provides a quick and systematic method of evaluating the level of consciousness and monitoring changes in the patient's neurological status over time, aiding in the management and prognosis of neurological injuries or conditions.