The Glasgow Coma
Scale (GCS) is used to objectively describe the extent of impaired
consciousness in all types of acute medical and trauma patients. The scale
assesses patients according to three aspects of responsiveness: eye-opening,
motor, and verbal responses. Reporting each of these separately provides a
clear, communicable picture of a patient. The findings in each component of the
scale can aggregate into a total Glasgow Coma Score which gives a less detailed
description but can provide a useful summary of the overall severity. The
Glasgow Coma Scale and its total score have since been incorporated in numerous
clinical guidelines and scoring systems for victims of trauma or critical
illness. This activity describes the use of the Glasgow Coma Scale and reviews
the role of using the scale for the interprofessional team to successfully
communicate a patients condition.
Objectives:
Introduction
The Glasgow Coma
Scale was first published in 1974 at the University of Glasgow
by neurosurgery professors Graham Teasdale and Bryan Jennet The
Glasgow Coma Scale (GCS) is used to objectively describe the extent of impaired
consciousness in all types of acute medical and trauma patients. The scale assesses
patients according to three aspects of responsiveness: eye-opening, motor, and
verbal responses. Reporting each of these separately provides a clear,
communicable picture of a patient’s state.
The findings in each
component of the scale can aggregate into a total Glasgow Coma Score which
gives a less detailed description but can provide a useful ‘shorthand’ summary
of the overall severity.The score expression is the sum of the scores as well
as the individual elements. For example, a score of 10 might be expressed as
GCS10 = E3V4M3.
Function
Scoring
and Parameters
The Glasgow Coma
Scale divides into three parameters: best eye response (E), best verbal
response (V) and best motor response (M). The levels of response in the
components of the Glasgow Coma Scale are ‘scored’ from 1, for no response,
up to normal values of 4 (Eye-opening response) 5 ( Verbal response) and 6
(Motor response)
The total Coma Score
thus has values between three and 15, three being the worst and 15 being the
highest.
The score is the sum
of the scores as well as the individual elements. For example, a score of 10
might be expressed as GCS10 = E3V4M3.
Best
eye response (4)
Best
verbal response (5)
Best
motor response (6)
Issues
of Concern
The following factors
may interfere with the Glasgow Coma Scale assessment:
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