The Glascow Coma Scale
The Glascow Coma Scale is one tool used to assess the depth of coma when a person has a Traumatic Brain Injury. It is also used to make predictions about how well such a person is likely to recover.
The Center for Disease Control provides a helpful description of the Glascow Coma Scale, and explains how the three sections of the scale are used to track the condition of a patient.
The three scales are: (1) Best motor response; (2) Best Verbal Response; and (3) Eye opening. Patients are rated on particular responses within the three categories. In essence, the lower the score, the deeper the coma.
For more details regarding the Glascow Coma Scale, click on "continue reading" below.
The following is taken directly from the website of the Center for Disease Control:
Glascow Coma Scale
Eye Opening ResponseSpontaneous--open with blinking at baseline 4 points
To verbal stimuli, command, speech 3 points
To pain only (not applied to face) 2 points
No response 1 point
Verbal ResponseOriented 5 points
Confused conversation, but able to answer questions 4 points
Inappropriate words 3 points
Incomprehensible speech 2 points
No response 1 point
Motor ResponseObeys commands for movement 6 points
Purposeful movement to painful stimulus 5 points
Withdraws in response to pain 4 points
Flexion in response to pain (decorticate posturing) 3 points
Extension response in response to pain (decerebrate posturing) 2 points
No response 1 point
References
Teasdale G, Jennett B. Assessment of coma and impaired consciousness. Lancet 1974; 81-84.
Teasdale G, Jennett B. Assessment and prognosis of coma after head injury. Acta Neurochir 1976; 34:45-55.
Categorization:
Coma: No eye opening, no ability to follow commands, no word verbalizations (3-8)Head Injury Classification:
Severe Head Injury----GCS score of 8 or less
Moderate Head Injury----GCS score of 9 to 12
Mild Head Injury----GCS score of 13 to 15
(Adapted from: Advanced Trauma Life Support: Course for Physicians, American College of Surgeons, 1993).Disclaimer:
Based on motor responsiveness, verbal performance, and eye opening to appropriate stimuli, the Glascow Coma Scale was designed and should be used to assess the depth and duration coma and impaired consciousness. This scale helps to gauge the impact of a wide variety of conditions such as acute brain damage due to traumatic and/or vascular injuries or infections, metabolic disorders (e.g., hepatic or renal failure, hypoglycemia, diabetic ketosis), etc.Education is necessary to the proper application of this scale.
Teasdale G, Kril-Jones R, van der Sande J. Observer variability in assessing impaired consciousness and coma. J Neurol Neurosurg Psychiatry 1978; 41:603-610; Rowley G, Fielding K. Reliability and accuracy of the Glasgow Coma Scale with experienced and inexperienced users. Lancet 1991; 337:535-538). The predictive value of the GCS, even when applied early, is limited (Waxman K, Sundine MJ, Young RF. Is early prediction of outcome in severe head injury possible? Arch Surg 1991; 126:1237-1242).Despite these and other limitations (Eisenberg HM. Outcome after head injury: Part I: general Considerations, in Becker DP, Povlishock JR (eds): Central Nervous System Trauma Status Report, 1985. Washington, DC: U.S. Government Printing Office, 1988:271-280), health care practitioners continue to use this practical scale widely.
Source: Adapted from Glascow Coma Scale, Womack Army Medical Center, Fort Bragg, NC.
Eyeopening but not registering
slight movements.
Hands and feet are turning inwards.
Hospital rating 4.
What is the changes of recovery?
9 days not waking up properly. On Oxygen machine. Please advice
IS THE SCALE A STANDARD MEASURE USED ONLY IN HOSPITAL SETTINGS? SITE SETUP IS EASY TO NAVIGATE,VERY NECESSARY.THANX!
The glascow coma scale is used in many settings. Many years ago I used it as an emergency medical technician is assessing trauma victims.