Basically it is a quick and dirty method of determining the patient's neurological status and can be used to compare groups of patients.
It was developed in 1974 by two neurosurgeons at the University of Glasgow.
Simply put, it is:
The score is calculated as the best response in each of three areas, Eye Opening, Verbal response and motor response.
Eye Opening has 4 possible points
Verbal response has 5 possible points
Motor response has 6 possible points.
Another version of the above scale is:
| 1 | 2 | 3 | 4 | 5 | 6 | |
|---|---|---|---|---|---|---|
| Eyes | Does not open eyes | Opens eyes in response to painful stimuli | Opens eyes in response to voice | Opens eyes spontaneously | N/A | N/A |
| Verbal | Makes no sounds | Incomprehensible sounds | Utters inappropriate words | Confused, disoriented | Oriented, converses normally | N/A |
| Motor | Makes no movements | Extension to painful stimuli (decerebrate) | Abnormal flexion to painful stimuli (decorticate) | Flexion / Withdrawal to painful stimuli | Localizes painful stimuli | Obeys commands |
The lowest possible score is 3 - does not open eyes, make sounds or move.
The best score is 15.
If the patient is intubated, they get a 1 for verbal (no sounds) with the designation "T" to indicate the presence of an artificial airway. The lowest score possible is 3T and the highest is 11T (eyes=4 + motor=6 + verbal=1).
An easy way to categorize the patient's severity of head injury using the GCS is:
Minor head injury GCS = 13-15
Moderate head injury GCS = 9-12
Severe head injury GCS = 3-8
Obviously this is an oversimplification but is useful to give an idea of how bad the head injury is.
It is difficult to calculate a GCS in a young child with the biggest difference in the verbal component:
The verbal scale changes to:
- Smiles, oriented to sounds, follows objects, interacts.
- Cries but consolable, inappropriate interactions.
- Inconsistently inconsolable, moaning.
- Inconsolable, agitated.
- No verbal response.
No comments:
Post a Comment