Makindo Medical Notes

Related Subjects: |Assessing Coma and Management |Glasgow Coma scale |Acute Poisoning |Trauma: Traumatic Brain Head Injury (TBI)

GCS is a very useful score. Changes may be more important than actual values. I always encourage doctors to say what patients can do rather than discuss just numbers. It gives us a useful framework to discuss comatose patients. Be sensible, a dysphasic patient perhaps due to a stroke affecting speech areas may have no speech but should not really be graded as a 1 without explicitly saying he/she is dysphasic. Patients at GCS of 8 and below tend to be intubated to protect the airway and prevent hypoxia and aspiration pneumonitis. If GCS is reduced always seek senior support. See Coma

introduction

• The Glasgow Coma Scale (GCS) is a clinical tool used to assess a patient's level of consciousness after a head injury or in other medical conditions that can affect the brain.
• It evaluates three aspects of a patient's responsiveness: eye-opening, verbal response, and motor response.
• The scale provides a score ranging from 3 to 15, where 3 indicates deep unconsciousness, and 15 indicates full alertness.

Scoring

• The GCS score is the sum of the three components: E (Eye Opening) + V (Verbal Response) + M (Motor Response).
• GCS Score Range: 3 to 15
• Severe: GCS 8 or less
• Moderate: GCS 9-12
• Mild: GCS 13-15

How to Perform GCS Assessment:

• Assess eye-opening first by observing if the patient opens their eyes spontaneously or after stimulation.
• Assess verbal response by asking simple questions (e.g., "What is your name? Where are you?"). Evaluate their responses based on orientation, clarity, and appropriateness.
• Assess motor response by giving a simple command ("Show me two fingers"). If unresponsive, apply painful stimuli and observe for any response (withdrawal, flexion, or extension).

Note: If intubated or aphasic, the verbal component is not assessable; this should be noted and scored as "V-NT" (Verbal: Not testable).

Total GCS Score Interpretation

• Mild Head Injury: GCS 13-15
• Moderate Head Injury: GCS 9-12
• Severe Head Injury: GCS 3-8

Usage

The Glasgow Coma Scale (GCS) is commonly used in emergency and critical care settings to assess and monitor the level of consciousness in patients with acute brain injuries. It is a key tool in guiding treatment decisions and predicting outcomes in head trauma cases.

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