Video-Understanding the Glasgow Coma Scale

Oct 16, 2024

Take quiz

Glasgow Coma Scale (GCS)

Introduction

  • Presented by Sarah, a registered nurse from Register Nurse RN.com.
  • Glasgow Coma Scale (GCS) is a tool used to assess a patient's level of consciousness.
  • Helps evaluate patients with traumatic brain injuries or altered brain functioning.

Importance of GCS

  • Determines alertness and responsiveness of a patient to their environment.
  • Establishes a baseline score to monitor changes over time.
  • Alerts to improvement, deterioration, or no change in patient's condition.

GCS Assessment Components

  1. Eye Opening Response
  2. Verbal Response
  3. Motor Response

Types of Stimuli

  • Central Stimuli: Tests brain response, e.g., trapezius squeeze, supraorbital pressure.
  • Peripheral Stimuli: Tests spinal cord response, e.g., nails pressure.
  • Avoid sternal rub due to bruising risk.

Scoring System

  • Scores range from 3 (deep coma or death risk) to 15 (fully alert).
  • Severe Brain Injury: 3-8
  • Moderate Brain Injury: 9-12
  • Mild Brain Injury: 13-15

Eye Opening Response (4 points max)

  • 4: Spontaneous eye opening.
  • 3: Eyes open to verbal stimulus.
  • 2: Eyes open to painful stimulus.
  • 1: No response.

Verbal Response (5 points max)

  • 5: Oriented, correct answers to questions.
  • 4: Confused but can answer questions.
  • 3: Inappropriate words.
  • 2: Incomprehensible sounds.
  • 1: No response.

Motor Response (6 points max)

  • 6: Obeys commands (two-step to verify).
  • 5: Localizes pain (moves hand to pain source).
  • 4: Withdraws from pain (normal flexion).
  • 3: Abnormal flexion (decorticate posturing).
  • 2: Extension (decerebrate posturing).
  • 1: No response.

Factors Affecting GCS

  • Injuries, sedation, intubation, paralysis, mental deficits can impact scores.
  • Use NT (not testable) if unable to assess certain responses due to physical limitations.

Reporting GCS

  • Total GCS score is important.
  • Sub-scores for eye, verbal, and motor responses provide additional insight.
  • Example: GCS of 6T indicates intubation with specific sub-scores.

Example Calculation

  • Eye Opening: 2 (pressure opens eyes)
  • Verbal: 2 (makes sounds only)
  • Motor: 5 (localizes pain)
  • Total GCS: 9

Conclusion

  • GCS is a critical tool for assessing brain injury severity.
  • Regular reassessment helps in patient monitoring and management.

Note: Access the free quiz linked in the video description to test your understanding of the Glasgow Coma Scale.