Written by Dave
Monday, 25 February 2008 10:11
The Glasgow Coma Scale (GCS)
About the scale
The GCS is one of the most common methods used in hostpitals and trauma units to reliably record the state of a head injured patient. It provides a standard by which the patients condition can be juged against.
It can also be useful for a patients family. Using the following chart, you can chart your own score, compare it to the official medical teams evaluation and use it as a tool to record improvement as time passes.
The initial condition and the rate at which improvements ocour can be a good guidline to long term expectations of recovery.
How to use the chart
Three types of response are independently assessed and are recorded on the chart, the overal score of the three types of response are then used for evaluation.
How to interpret the chart
The overal score can be used to indicate the severity of the head injury as:
Less than 8, Severe Head Injury
Score 9 - 12, Moderate Head Injury
Score 13 - 15, Mild Head Injury
Note: a downloadable version of the chart ( pdf format ) can be found in our download area.
|1. Best Motor Response (6 grades) |
1. No response to pain.
2. Extensor posturing to pain: The stimulus causes limb extension (adduction, internal rotation of shoulder, pronation of forearm) - "decerebrate posture"
3. Abnormal flexor response to pain: Pressure on the nail bed causes abnormal flexion of limbs - "decorticate posture".
4. Withdraws to pain: Pulls limb away from painful stimulus.
5. Localizing response to pain: Put pressure on the patient's finger nail bed with a pencil then try supraorbital and sternal pressure: purposeful movements towards changing painful stimuli is a 'localizing' response.
6. Obeying command: The patient does simple things you ask (beware of accepting a grasp refles in this category).
|2. Best Verbal Response (5 grades) Record best level of speech. If patient is intubated, a "derived verbal score" is calculated via a linear regression prediction. |
2. Incomprehensible speech: Moaning but no words.
3. Inappropriate speech: Random or exclamatory articulated speech, but no conversational exchange.
4. Confused conversation: Patient responds to questions in a conversational manner but some disorientation and confusion.
5. Orientated: Patient knows who he is, where he is and why, the year, season, and month.
|3. Eye Opening (4 grades) |
1. No eye opening;
2. Opening to response to pain to limbs as above
3. Eye opening in response any speech (or shout, not necessarily request to open eyes);
4. Spontaneous eye opening.
Interpretation of Symptoms:
Severe: less than 8;
| Total Score|
Last Updated ( Monday, 25 February 2008 10:54 )