THE GLASGOW

COMA SCALE
Dr. Ceryl G. Sagun, MAN, RN
Manuel V. Immaculata, MAN, RN
What is the Glasgow Coma Scale (GCS)?
 The Glasgow Coma Scale is a neurological scale that
provides an easy, reliable, and objective way of assessing
the patients' level of consciousness. 
 It helps gauge, detects and interprets a patient's condition
after a traumatic brain injury (TBI) from the initial and the
continuing assessment of any changes that occur. 
 The tool was developed in 1974 at the University of
Glasgow by neurosurgery professors Graham
Teasdale and Bryan Jennett, to measure the patient's
awareness and responsiveness, as well as, a marker on
the severity of the head injury.
 To use the tool, you need to test the patient's ability to
respond to each subset and rate the best response a
patient makes.
, DR. CERYL G. SAGUN, MAN, RN/ MANUEL V. IMMACULATA, MAN, RN
 THE GLASGOW COMA SCALE
 The GCS is divided into subsets of behavior; Eye-opening
(E), verbal response (V), and motor responsiveness (M). 
Each component is assessed independently using the
following values (Table1).
 The final GCS score or grade is the sum of these numbers.
 GCS scores range from 3 to 15 where the highest possible
score is 15 while the lowest is 3.  If a patient is alert, it can
follow simple commands and is oriented to time, place, and
person. The equivalent score will total 15 points.
 Any decreased score in one or more categories may
indicate an impending neurologic crisis. A total score of 7
or less implies severe neurologic damage.

, DR. CERYL G. SAGUN, MAN, RN/ MANUEL V. IMMACULATA, MAN, RN

 GLASGOW COMA SCORE

EYE OPENING (E) BEST VERBAL BEST MOTOR

RESPONSE (V) RESPONSE (M)
4 - Spontaneous 5- Oriented
6 - Obeys command
3 - To voice 4- Confused
5- Localizes to pain
3- Inappropriate words 4-Withdraws
2 - To pain
2- Incomprehensible 3- Flexion
1- None
sounds 2- Extension
1- None 1- None

Source: Brunner and Suddarth’s Textbook on Medical-Surgical Nursing

, DR. CERYL G. SAGUN, MAN, RN/ MANUEL V. IMMACULATA, MAN, RN

Level of Consciousness and Clarity of Thought

 Are indicators of cerebral perfusion.

a.ALERT: mentally functioning
b.CONFUSED: poor mental coordination
c.OBTUNDED: sleepy, can respond appropriately when
aroused or stimulated.
d.STUPOROUS: difficult to arouse, responds only to
vigorous stimulation
e.LIGHT COMA: grimaces and withdraws to painful
stimulation
f. DEEP COMA: no observable response to painful
stimulation
(Clayton, Bruce D.)
, DR. CERYL G. SAGUN, MAN, RN/ MANUEL V. IMMACULATA, MAN, RN
 Copyright 1997-2016, A.D.A.M., Inc. Duplication for commercial use must be
authorized in writing by ADAM Health Solutions.

, DR. CERYL G. SAGUN, MAN, RN/ MANUEL V. IMMACULATA, MAN, RN