The Glasgow Coma Scale (GCS) is a neurological scale that assesses the level of consciousness in patients with a brain injury. It is a widely used and reliable tool to determine the severity of brain damage and to monitor the progression of recovery.
The GCS measures three aspects of brain function:
- Eye-opening
- Verbal response
- Motor response
Each aspect is scored on a scale of 1 to 4, 1 to 5 or 1 to 6, depending on the particular response observed, with higher scores indicating a better level of consciousness.
The total score is calculated by adding the individual scores for eye-opening, verbal response and motor response, resulting in a range from 3 (indicating deep unconsciousness) to 15 (indicating normal consciousness).
| Eye Opening | |
| Spontaneous | 4 |
| To voice | 3 |
| To pain | 2 |
| None | 1 |
| Verbal Response | |
| Orientated | 5 |
| Confused | 4 |
| Inappropriate words | 3 |
| Incomprehensible sounds | 2 |
| None | 1 |
| Motor Response | |
| Obeys commands | 6 |
| Localises to pain | 5 |
| Withdraws to pain | 4 |
| Flexion to pain | 3 |
| Extension to pain | 2 |
| None | 1 |
Several factors can effect a patient’s Glasgow Coma Scale (GCS) score, including:
- Medications: Some medications can cause drowsiness or confusion, which can affect a patient’s level of consciousness and, therefore, their GCS score.
- Intoxication: Alcohol and drugs can impair a person’s level of consciousness and cognitive function, leading to a lower GCS score.
- Pre-existing medical conditions: Patients with pre-existing medical conditions that affect their neurological function, such as dementia or stroke, may have a lower GCS score than patients without these conditions.
- Age: Older patients may have a lower GCS score due to age-related changes in the brain.
- Head injury: The GCS is primarily used to assess patients with head injuries, and the severity of the injury can affect the GCS score.
- Language barriers: Patients who do not speak the same language as their healthcare provider may have difficulty communicating, which can affect their GCS score.
Therefore, when assessing a patient’s level of consciousness, GCS is one tool combined with other factors that should be taken into consideration when determining a patient’s overall condition.