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Glasgow Coma Scale
Eye-opening π
| Action | GCS Score | |
| Spontaneous eye-opening π | Open their eyes with no prompting | 4 |
| Eye-opening in response to sound π | βcan you hear meββ | 3 |
| Eye-opening in response to pain π | pressure on fingertips, trapezius squeeze, pressure on supraorbital notch | 2 |
| No eye opening π | Do not open eyes at all β | 1 |
| Not testable π | trauma prevents them opening their eyes β | NT |
Verbal response Askβ: |
| Action | GCS Score | |
| Orientated response | Appropriate responses β
| 5 |
Confused conversation | Patient responds but seems confusedβ | 4 |
| Inappropriate words | Patient says random words that do not answer the questionβ | 3 |
| Incomprehensible noises | Patient is making sounds not saying words | 2 |
| No response | No words or sounds β | 1 |
| Not testable | Incubation prevents them from making any sound β | NT |
|
Motor Response |
Score the patient according to their highest score, obtained from any limb:
| Action | GCS Score | |
| Obeys command | Patient performs 2 step command e.g. βlift arm and make fistβ | 6 |
| Localises to pain | Patient attempts to reach towards site of pain e.g. trapezius squeeze/pressure on supraorbital notch β | 5 |
| Withdraws from pain | Patient flexes arm rapidly at elbow, attempting to move away from pain | 4 |
| Abnormal flexion response to pain | Decorticate posture: stiff, straight legs, clenched fists on the chest as the arms are bent (shown below), indicates significant brain damage π§ | 3 |
| Abnormal extension response to pain | Decerebrate posture: straight arms and legs with pointed toes and arched back head (shown below), indicates brain stem damage π§ | 2 |
| No response | No motor response to pain β | 1 |
| Not testable | e.g. paralysis prevents motor response β | NT |
|
Completion β |
Add the patientβs 3 scores together to calculate their GCS Score
Document the breakdown of scores β
The highest possible score is 15 indicating that the patient is fully conscious β¬
The lowest possible score is 3 indicating that the patient is either dead or in a coma β¬
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