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Understanding the Glasgow Coma Scale

Apr 24, 2025

Lecture Notes: Glasgow Coma Scale by Mark Kimi

Introduction

  • Speaker: Mark Kimi, Registered Nurse (RN)
  • Role: President and CEO of Climic Connect
  • Purpose: To help nurses prepare for NCLEX exams and enhance professional knowledge.
  • Series: Episode 7 in the series "Walk through the Blue Book."
  • Resource: The Blue Book, available on Amazon or with Climic Connect programs.

Glasgow Coma Scale (GCS)

  • Development: Created in 1974 at the University of Glasgow, Scotland.
  • Purpose: To provide an objective measurement of a patient's level of consciousness over time, as opposed to subjective terms like "lethargic" or "obtunded."

Components of GCS

  • Three Main Areas:

    1. Eye Response (E)
      • Best score: 4
    2. Verbal Response (V)
      • Best score: 5
    3. Motor Response (M)
      • Best score: 6

  • Total Score: Sum of E, V, M scores, with a maximum of 15.

    • 15: Fully alert and oriented.
    • 8 or below: Severe brain injury or coma.
    • 12: Moderate brain injury.
    • 13 or 14: Minimal brain injury.

Scoring Interpretation

  • Higher Score: Indicates better neurological status.
  • Lower Score: Indicates worse neurological status.
  • Key Assessment: Always record the patient's best response.
    • Example: If a slight eye blink occurs once, score for that response.

Pupillary Response (PRS)

  • Not Included in Original GCS: Introduced in 2011, refined in 2018.
  • Scoring:
    • 0: Both pupils react appropriately.
    • 1: One pupil reacts, the other doesn't.
    • 2: Neither pupil reacts.

GCS minus PRS

  • Calculation: GCS score minus PRS score.
    • Example: A GCS of 12 with no pupil response (PRS of 2) results in a score of 10.
    • A score of 15 with both pupils reacting (PRS of 0) remains 15.

Conclusion

  • Utility: Understanding and using GCS helps in accurately assessing and communicating a patient's neurological status.
  • Further Learning: Encourage others to join Climic Connect for more sessions and resources.

Contact and Resources

  • Climic Connect: Join for more insights, reviews, and preparation materials.
  • Website: Thinkific for session access.

This summary captures the key points from the talk on the Glasgow Coma Scale, providing an understanding of its components, usage, and importance in neurological assessment.

Full transcript