Overview
This lecture explains the Glasgow Coma Scale (GCS), including its scoring, sections, and how to remember it for exams and patient assessment.
GCS Basics and Mnemonics
- The GCS assesses a patient’s level of consciousness using Eye, Verbal, and Motor (EVM) responses.
- Scores range from 3 (unresponsive) to 15 (fully alert and oriented).
- Use the mnemonic "456 EVM" — Eyes (4), Verbal (5), Motor (6) as maximum points for each section.
- Each section's lowest possible score is 1 (unresponsive).
GCS Section Breakdown
Eye Opening (E, max 4 points)
- 4: Spontaneous (eyes open on their own)
- 3: To verbal command (eyes open when spoken to)
- 2: To pain (eyes open to painful stimulus)
- 1: No eye opening
Verbal Response (V, max 5 points)
- 5: Oriented (normal conversation)
- 4: Confused (speaks full sentences but is disoriented)
- 3: Inappropriate words (random or inappropriate words, not full sentences)
- 2: Incomprehensible sounds (grunts, moans, no words)
- 1: No verbal response
Motor Response (M, max 6 points)
- 6: Obeys commands (follows simple instructions)
- 5: Localizes pain (purposefully moves toward painful stimulus)
- 4: Withdraws from pain (pulls away from pain, but not purposeful)
- 3: Abnormal flexion (decorticate posturing—arms flexed to chest)
- 2: Abnormal extension (decerebrate posturing—arms extended outward)
- 1: No motor response
Example Scenario: Practice Question
- Patient: Inappropriate words (V3), withdraws from pain (M4), eyes open to verbal command (E3).
- Total GCS: 3 (V) + 4 (M) + 3 (E) = 10
Key Terms & Definitions
- GCS (Glasgow Coma Scale) — A scale to assess consciousness in trauma or critically ill patients.
- EVM — Eye, Verbal, Motor; the three categories of GCS.
- Decorticate posturing — Abnormal flexion, arms to the core (score 3 in motor).
- Decerebrate posturing — Abnormal extension, arms extended outward (score 2 in motor).
Action Items / Next Steps
- Memorize the EVM 4-5-6 scoring system for each GCS section.
- Practice scoring with real or sample patient scenarios.
- Review abnormal posturing (decorticate and decerebrate) for motor response.