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Glasgow Coma Scale (GCS)

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Glasgow Coma Scale: Explanation with a case study

The Glasgow Coma Scale Is Based On a 15 Point Scale Used For Estimating And Categorising The Severity Of Brain Injury.

glasgow-coma-scale

Following A Traumatic Brain Injury (TBI). The Test Measures The Motor Response, Verbal Response, And Eye-Opening Response With The Following Scoring Scheme:

Eye ResponseSpontaneous Eye Opening4 Points
Opens To Verbal Command, Speech, Or Shout3 Points
Opens To Pain, Not Applied To Face2 Points
No Eye Opening1 Point
Verbal ResponseAlert And Oriented5 Points
Confused Conversation, But Able To Answer Questions4 Points
Inappropriate Responses, Jumbled Phrases, But Discernible Words3 Points
Incomprehensible Speech2 Points
No Sounds1 Points
Motor ResponseObeys Commands For Movement Fully6 Points
Localises To Noxious Stimuli5 Points
Withdraws From Noxious Stimuli4 Points
Abnormal Flexion, Decorticate (Towards The Core Of The Body ) Posturing3 Points
Extensor Response, Decerebrate (Celebrate Away From Body)  Posturing2 Points
No Response1 Point

Let’s take the example of starting an iv on a confused patient:

If your patient simply pulls the hand that you are starting the i.v. in away from you, they have withdrawn from pain (4).   If they use the opposite hand to cross the midline and try to push the stimulus away, they have localised the pain (5).   The Levels Of Brain Injury Severity Are Classified As:

SeverityGCS Score
Severe             3 – 8
Moderate             9 – 12
Mild                   13 – 15
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