Glasgow coma scale (GCS)
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Indications
- patients with moderate to severe head injuries
Procedure
- consciousness may be assessed by the Glasgow Coma Scale (GCS).
- points are assigned & totaled based upon the patient's response to stimuli
- range: 3 (unresponsive) to 15 (normal).
| type of response | response | points |
|---|---|---|
| Eye opening | spontaneous | 4 |
| Eye opening | to voice | 3 |
| Eye opening | to painful stimuli | 2 |
| Eye opening | never | 1 |
| Verbal responses | oriented | 5 |
| Verbal responses | confused | 4 |
| Verbal responses | inappropriate words | 3 |
| Verbal responses | unintelligible sounds | 2 |
| Verbal responses | none | 1 |
| Motor responses | follows commands | 6 |
| Motor responses | localizes pain | 5 |
| Motor responses | withdraws from pain | 4 |
| Motor responses | flexor response | 3 |
| Motor responses | extensor response | 2 |
| Motor responses | none | 1 |
Interpretation
- if score < 8, consider endotracheal intubation
Notes
- elderly with a GCS of 14 have a worse prognosis than young adults with a GCS score of 13[2]
- simple finding of 'patient does not follow commands' is as predictive as Glascow Coma Scale[3]
More general terms
Additional terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
- ↑ 2.0 2.1 Caterino JM et al. Modification of Glasgow Coma Scale criteria for injured elders. Acad Emerg Med 2011 Oct; 18:1014 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21951715
- ↑ 3.0 3.1 Hopkins E, Green SM, Kiemeney M, Haukoos JS. A two-center validation of "patient does not follow commands" and three other simplified measures to replace the Glasgow Coma Scale for field trauma triage. Ann Emerg Med 2018 May 2 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29729813 https://www.annemergmed.com/article/S0196-0644(18)30312-3/fulltext