Understanding Glasgow Coma Scale (GCS)

Introduction

• Glasgow Coma Scale (GCS) is a clinical tool to assess a patient's level of consciousness.
• Useful for evaluating a patient who has suffered trauma or injury, especially brain-related.
• The scale is divided into three categories: Eye response (E), Verbal response (V), and Motor response (M).
• Total GCS score ranges from 3 (lowest) to 15 (highest), with 15 indicating full consciousness.

Example Question

• Scenario: An 84-year-old woman who fell.
  • Verbal: Speaks with scattered, inappropriate words = 3 points.
  • Motor: Withdraws from pain = 4 points.
  • Eyes: Eye opening to verbal command = 3 points.
• Total GCS for this patient: 10 points.

Mnemonic for Remembering GCS

• EVM 4 5 6: Eye response (4), Verbal response (5), Motor response (6).
• 111: Each unresponsive category scores a 1.

GCS Scoring Details

Eye Response (E)

• 4: Spontaneous opening.
• 3: Eye opening to verbal command.
• 2: Eye opening to painful stimulus.
• 1: No eye opening (unresponsive).

Verbal Response (V)

• 5: Oriented conversation.
• 4: Confused conversation (e.g., dementia).
• 3: Inappropriate words (random words not related to context).
• 2: Incomprehensible sounds (grunts, moans).
• 1: No verbal response (unresponsive).

Motor Response (M)

• 6: Obeys commands.
• 5: Localizes pain (can identify painful area).
• 4: Withdraws from pain.
• 3: Abnormal flexion to pain (decorticate posturing).
• 2: Abnormal extension to pain (decerebrate posturing).
• 1: No motor response (unresponsive).

Applying GCS

• Top score of 15 means patient is fully conscious and responsive.
• Lowest score of 3 indicates complete lack of responsiveness, often seen in cardiac arrest.

Tips for Remembering

• Visualize the scale from high to low to understand the patient's condition.
• Differentiate between responses to verbal and painful stimuli.
• Practice with scenarios to solidify understanding of GCS evaluations.

Additional Resources

• Consider joining study groups or educational platforms for further support and practice.
• Engage with community groups for peer discussions and expert guidance.