watch this entire video you will never forget gcs again here we go hey everyone paramedic coach here i got another nramt prax question for you then we're gonna go over and understand gcs cold make sure to hit like smash annihilate that like button down below hit subscribe and let's unveil the question so you are called to an 84 year old female who has fallen now she's speaking with scattered words okay inappropriate words withdraws from pain and the eye opening is found on your verbal command what's the gcs start the clock 5 4 3 2 1 the answer is is it a 10 b13 c12 or d9 what do you got put your answer in the comments down below and the answer is here's why it is 10 a 10. now she's speaking with scattered words inappropriate words meaning that's three three points that's the verbal which draws from pain is the motor that's gonna be four okay now eye opening on verbal command that is a three six and four we got ten here there's ten now i wanna show you how to never forget gcs ever again gcs456 evm456 that's the mnemonic for you when you think of the glasgow coma scale when we think about this what i want you to think about is e v m 4 5 6. i also want you to think of one one one let me explain this now we have three sections okay you can see right here i have it built up for you we have here the eye opening section the verbal response section and the motor response section that's the e v m okay why do i say 456 because the top number in the eyes is four type number in the verbal is five type number in the motor is six why do i say one one one because each unresponsive is a one so what does that mean what that means is 15 is a perfect score that is a patient who like right now i'm 15 right now a patient who is in cardiac arrest would be a three so if someone totally unresponsive to three alert oriented person is all the way over at 15 right it's maintaining high opening obeying commands or an oriented 15. once we know 15 and 3 all we need to do now is understand the middle and we got it cold now the patient we had in the question she had eye opening to verbal stimulus she got three points then she had inappropriate words so she ended up at three and then withdraw some pain was four that's how we got to ten now i'm going to break this down so we can always remember this okay now hear me out we have the top and the bottom number set in each one so let's break down the middle piece so with eye opening we go from spontaneous eye opening which is you what you walk up to the patient their eyes are open if you because they called their name that would be a verbal stimulus right and their eyes opened then right that would be a three if you try to call the name your eyes don't open let's say you did a sternal rub right or you pinch their finger right painful stimulus then their eyes open up okay that's two if none of that happens it's a one right so we think here the eyes are open we talk to patients painful stimuli or unresponsive that's it so that's the first section done next section verbal we have completely unresponsive again think about cardiac arrest and then right me right now or an oriented now what's one step down well what i think about is like a dementia patient they're they're fine but they're confused right this is the confusion level they're speaking in full sentences they're just confused they just are not aware now what's going on that's confusion that's four points now these two there's no reason to mess these two up but everyone forgets them here's what it is so confusion means i'm speaking in full senses but i'm unaware of what's going on i'm just confused right think about like again a dementia patient inappropriate words means that let's say you're asking a patient a question and there are just random words it does not make any sense as far as a conversation and also can be looked at as just random one or two words being spewed out right you're able to understand it but it's inappropriate to the actual situation but you're getting words out that's inappropriate words now number two here before responsive i want you to think sounds not words okay so i remember it so we're still getting out words here at three and number two it's like it's you know it's grunting it's just noises right so the your verbal you're still able to make some sort of speech but it's not words it's not senses you're not confused it's just noises are coming out of your mouth it's in word is sounds not words it's noises ones are unresponsive nothing okay so we can picture that patient as they go down to unresponsive right words sounds confusion confusion words sounds that's how you remember it now motor we got six obey commands one unresponsive let's fill in the middle now this has to do this actual part with a painful stimulus and how the patient responds to a painful stimulus right so if they obey commands okay six one unresponsive five means the patient is able to localize where the pain is so let's say they have an arm injury they can say oh my arm i think they're holding their arm they're holding their arm they can feel the arm right then i'll bang commands though localizes pain withdrawals from pain would mean let's say you were storing it let's say you were throwing an iv in the patient they started to pull away and they pull away they were strong from the pain so they can still sense that right but they're moving away from it withdrawals from pain now here is there's two fancy ones if you will abnormal flexion and abnormal extension now here's the best way i can describe it to you if you go up let's say you go up to your patient the corticate posturing to the core towards the core so what i have is abnormal flexion well extension is out like this flexion is in like this so i'm gonna flex in like this this is the actual decorative posturing it's something like this okay now the other one here the adderall flexion which we have here the cerebral is like this so i can't see my wrist i'm going to move my wrist out like this see how the normal i go like this bring him to the side and i'm extending and i'm like this that is the maneuver so we go to coordinate three two this is the posturing of the patients one unresponsive right think a classic cardiac arrest try to put it in your head so we go down from that obeying commands localizing i see what the pain is i'm just withdrawing from the pain we have a coordinate posturing we have a cerebral posturing and then we have a responsive and there it is congrats on getting through this gcs video if you are someone getting ready for school maybe you're in school right now or getting ready for your nramt exams and you want to learn more and get this information ems education down cold i want you to hit the first link in the description i'll give you a lifetime access right now to my video vault it also includes our community group student group where you can ask me questions while you're in school while you're studying i will see you on the inside there and i will see you in the next video take care you