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here. Glasgow Coma Scale
Eye Opening Response
-
Spontaneous--open
with blinking at baseline 4 points
-
To
verbal stimuli, command, speech 3 points
-
To
pain only (not applied to face) 2 points
-
No
response 1 point
Verbal Response
-
Oriented
5 points
-
Confused
conversation, but able to answer questions 4 points
-
Inappropriate
words 3 points
-
Incomprehensible
speech 2 points
-
No
response 1 point
Motor Response
-
Obeys
commands for movement 6 points
-
Purposeful
movement to painful stimulus 5 points
-
Withdraws
in response to pain 4 points
-
Flexion
in response to pain (decorticate posturing) 3 points
-
Extension
response in response to pain (decerebrate posturing) 2 points
-
No
response 1 point
References
Teasdale G, Jennett B. Assessment of coma and impaired consciousness. Lancet
1974; 81-84.
Teasdale G, Jennett B. Assessment and prognosis of coma after head injury.
Acta Neurochir 1976; 34:45-55.
Categorization:
Coma: No eye opening, no ability to follow commands, no word verbalizations (3-8)
Head Injury Classification:
Severe Head Injury----GCS score of 8 or less
Moderate Head Injury----GCS score of 9 to 12
Mild Head Injury----GCS score of 13 to 15
(Adapted from: Advanced Trauma Life Support: Course for Physicians, American
College of Surgeons, 1993).
Disclaimer:
Based on motor responsiveness, verbal performance, and eye opening to
appropriate stimuli, the Glascow Coma Scale was designed and should be used to assess
the depth and duration coma and impaired consciousness. This scale helps to gauge the impact of a wide variety of conditions such as acute brain
damage due to traumatic and/or vascular injuries or infections, metabolic
disorders (e.g., hepatic or renal failure, hypoglycemia, diabetic ketosis), etc.
Education is necessary to the proper application of this scale.
Teasdale G, Kril-Jones R, van der Sande J. Observer variability in assessing
impaired consciousness and coma. J Neurol Neurosurg Psychiatry 1978;
41:603-610; Rowley G, Fielding K. Reliability and accuracy of the Glasgow Coma
Scale with experienced and inexperienced users. Lancet 1991; 337:535-538).
The predictive value of the GCS, even when applied early, is limited
(Waxman K, Sundine MJ, Young RF. Is early prediction of outcome in severe head
injury possible? Arch Surg 1991; 126:1237-1242).
Despite these and other
limitations (Eisenberg HM. Outcome after head injury: Part I: general
Considerations, in Becker DP, Povlishock JR (eds): Central Nervous System Trauma Status Report, 1985. Washington, DC: U.S. Government Printing
Office, 1988:271-280), health care practitioners continue to use this
practical scale widely.
Source: Adapted from Glascow Coma Scale, Womack Army Medical Center, Fort Bragg,
NC.
Page content last
revised 2/18/03.
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