May 18th, 2009

 Glasgow Coma Scale


What is Glasgow Coma Scale?

Glasgow Coma Scale is a neurological scale which aims to give a reliable, objective way of recording the conscious state of a person, for initial as well as continuing assessment. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3 (indicating deep comatose) and 15 (normal or very mild injury)

Published initially in 1974 by Graham Teasdale and Bryan J. Jennett, professors of neurosurgery at the University of Glasgow, Glasgow Come Scale is now widely used by doctors, EMS and first aid as the standard measure to quantify the level of consciousness of patients who have sustained head injuries. In hospital it is also used in routine patient neurological assessment.

Glasgow Coma Scale Assessment

Parameter

Patient Response

score

E

Best eye opening response (record “C”
if eyes closed because of swelling)

opens eyes spontaneously

4

open eyes to speech

3

open eyes to pains

2

no response (does not open eyes)

1

M

Best motor response (record best upper
limb response to painful stimuli)

 obeys verbal command

6

localizes pain

5

flexion/withdrawal, purposeless movement to painful stimuli

4
abnormal flexion to painful stimuli

3

extension to painful stimuli

2

no response (flaccid)

1

V

Best verbal response (record “E” if
endotrancheal tube is in place or “T” if tracheostomy tube is in place)

conversation-oriented x3

5

conversation-confused

4

utters inappropriate words

3

incomprehensible sounds

2

no sounds

1

GCS Total Score (E+M+V) = 3 to 15.

Generally, intrepretation of the GCS total score is as follows:

  • 15 = normal
  • 13-15 = minor head injury
  • 9-12 = moderate head injury
  • 3- 8 = severe head injury
  • <7 = coma
  • 3 = deep coma, brain death



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