The Glasgow Coma Scale is an integral part of clinical practice and research across the World. The experience gained since it was first described in 1974 has advanced the assessment of the Scale through the development of a modern structured approach with improved accuracy, reliability, and communication in its use.Sir Graham Teasdale
Glasgow Coma Scale – A standardized scale used for the assessment of neurological status, consciousness, and degree of brain injury. The scale scores the patient’s eye response (1–4 points), verbal response (1–5 points), and motor response (1–6 points). A maximum score of 15 points corresponds to full consciousness, while a minimum score of 3 points indicates coma or death. The degree of brain injury is classified as follows: Mild brain injury: 13–15 points Moderate brain injury: 9–12 points Severe brain injury: ≤ 8 points (indication for endotracheal intubation)
Glasgow Coma Scale – What is it?
All trauma patients should be first assessed using the GCS, which estimates the severity of the patient’s neurologic injury for triage. The GCS can also give some prognostic information when used in conjunction with the patient’s age and presence of concomitant adverse clinical findings, such as hypoxia, cardiovascular compromise, increased intracranial pressure, and radiographic evidence of a midline shift of the brain. Calculation of GCS score is shown below.
Glasgow Coma Scale – Used for what?
The GCS is used to predict the prognosis of coma and other medical conditions, such as bacterial meningitis, traumatic brain injury, and subarachnoid hemorrhage.
However, the GCS is not used to diagnose coma in a patient. Findings used to diagnose coma include impaired brainstem activity (e.g., disruption of the pupillary light, extraocular, and corneal reflexes), motor dysfunction (e.g., decorticate or decerebrate posturing), and impaired level of consciousness.