GLASGOW COMA SCALE

PREPARED BY: LOVELITES D. ZAMORA, RN

INTRODUCTION

Designed in 1974 by Graham Teasdale and Bryan J.

Jennett, professors of neurosurgery at the University
of Glasgow's Institute of Neurological Sciences
This scale is the gold standard used for all acute
medical and trauma patients.
DEFINITION AND PURPOSES
 A tool that has the ability to communicate
the level of consciousness of patients with
acute or traumatic brain injury
Medical scale designed to assess the depth
(and duration) of impaired consciousness and
coma states
Helps to measure acute and chronic brain
impairment within a trauma scene or during
hospitalization
Used to predict whether a victim or patient is
likely to die (prediction of mortality).
THREE DIFFERENT CRITERIA

1. Eye Opening
2. Verbal Response
3. Motor Response
*Each criteria is on a different
scale with a total possible
score of 15. The lowest
possible score is 3.
EYE RESPONSE

4-Spontaneous - Open before stimuluS

3-To Sound - After spoken request

2-To Pressure - After fingertip stimulus

1-None - No opening at any time, no

interfering factors
Closed by local factor - (NON TESTABLE)
VERBAL RESPONSE
1- None - No audible response, no interfering
factor

2- Sounds - Only moan/groans

3- Words - Intelligible single words

4-Confused - Not orientated but communicates

coherently

5- Oriented - Correctly gives name, place, and

date

Non-testable - Factor interfering with communication

 MOTOR RESPONSE
6-Obeys Commands - 2-part request

5-Localising - Brings hand above clavicle to stimulus on

head/neck

4-Normal Flexion - Bends arm at elbow rapidly but

features not predominantly abnormal

3-Abnormal flexion - Bends arm at elbow, features clearly

predominantly abnormal

2-Extension - Extends arm at elbow

1-None - No movement in arms/legs, no interfering factor

Non-testable - Paralysed or other limiting factor

 INTERPRETATIONS

Severe: GCS 3-8

Moderate: GCS 9-12
Mild: GCS 13-15
In trauma, a Glasgow Coma Scale score (GCS) of
8 or less indicates a need for endotracheal
intubation.
In intubated patients, the maximum GCS score
is 10T and the minimum score is 2T.
 Limitations of the GCS

Pre-existing facts Age (actual and

Language or cultural intellectual)
difference Current Treatment
Hearing loss or speech Physical
impediment Intubation
Intellectual or baseline Edema (swelling)
neurological deficit Tracheostomy
Baseline psychological Pharmacological
issues
 Limitations of the GCS

 Dysphasia (language
Sedation
disorder due to
Paralysis damage of the brain)
Other injuries/wounds/lesions
 Hemiplegia (paralysis
Orbital fracture of one side of the
Cranial fracture body)
Spinal cord damage  External Factors
 Alcohol
 Drugs