Glasgow Coma Scale
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The Glasgow Coma Scale (also known as Glasgow Coma Score or simply GCS) was first published by Glasgow-based Teasdale & Jennett (1974) to assess head trauma and, importantly, to help keep track of patients' progress over a period of time. The scale is comprised of three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma) whilst the highest is 15 (fully awake person). The Rancho Scale is used to assess awakening and recovering coma patients.
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Best eye response: (E)
- No eye opening
- Eye opening to pain
- Eye opening to speech
- Eyes opening spontaneously
Best verbal response: (V)
- No verbal response
- Incomprehensible sounds
- Inappropriate words
- Confused
- Orientated
Best motor responses: (M)
- No motor response
- Extension to pain (decerebrate response)
- Flexion to pain (decorticate response)
- Withdraws from pain (pulls part of body away when pinched)
- Localises pain (pulls examiner's hand away)
- Obeys commands
Interpretation
Individual elements as well as the sum of the score are important. Hence, the score is expressed in the form "GCS 9 = E2 V4 M3".
The GCS has limited applicability to children, especially below the age of 36 months (where the verbal performance of even a healthy child would be expected to be poor). Consequently the Pediatric Glasgow Coma Scale, a separate yet closely related scale, was developed for assessing younger children.
Reference
- Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974,2:81-84. PMID 4136544.de:Glasgow Coma Scale
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