The Glasgow Coma Scale (GCS) is a neurological scale used to assess consciousness after brain injury. It evaluates eye opening, verbal response, and motor response on a scale of 3 to 15, with lower scores indicating worse condition. The GCS was developed in 1974 and provides a standardized way to record a patient's state and classify brain injuries as mild, moderate or severe based on the total score. Limitations include inability to fully assess intubated or facially injured patients.

1. Prepared by practitioner :Soran Ismail

2. Objective
-Introduction
-definition
-eye score
-verbal score
-motor score
-Interpreation
-summary

3. Introduction
-The scale was published in 1974 by Graham
teasdale and bryan J.Jennett, professors of
neurosurgery at the university of Glasgow is institute
of neurological sciences at the city is southern
general hospital
- A patient is assessed against the criteria of the scale
and the resulting points give a patient score between
3 (indicating deep unconsciousness)to 15 (Full
consciosness)

4. Defination
- The Glasgow coma scale (GCS) is a neurological
scale which aims to give a reliable way of
recording the conscious state of a person .

5. Scale scoring
- GCS check 3 components
- Eye response (1-4)
- Verbal response (1-5)
- Motor response (1-6)

6. Eye Response (E)
- There are four grades starting with the most severe
4. Eyes opening spontaneously
3. Eye opening to speech.(not to be confused with the
awakening of a sleeping person : such patients receive a
score of 4, not 3.)
2. Eye opening in response to pain stimulus.(a peripheral
pain stimulus , such as squeezing the lunula area of the
patient fingernails more effective than a central stimulus
such as a trapezlus sequeez, due to a grimacing effect).
1.No eye opening

7. Verbal response (V)

8. Motor response (M)
6.Obeys commands (the patient does simple things
as asked )
5.Localizes to pain (Purposeful movements towards
painful stimuli:e.g, brings hand up beyond chin
when supra orbital pressure applied )
4.Withdrawal from pain (absence of abnormal
posturing ,unable to lift hand past chin with supra
orbital pain but does pull away when nail bed is
pinched)

9. Motor response (M)
3.Decorticate posturing accentuated by pain (flexor
response :internal rotation of shoulder ,flexion of
forearm and wrist with clenched fist ,fit,leg
,extension plantar flexion of foot )
2.Decerebrate posturing accentuated by pain (extensor
response ; adduction of arm,internal rotation of
shoulder ,flexion of wrist and fingers , leg extension ,
plantar flexion of foot)
1.No motor response .

12. Interpretation
Generally ,brain injury is classified as:
- Sever , GSC <8-9
-
-Moderate , GCS 8 or 9-12 (Controversial)
Monior,GSC>13
-

13. A- Alert (15)
V- Response to verbal stimulus (13)
P- Respond to stimulus ( 5 )
U-Un responsive (3 )

14. Limitation
-Tracheal intubation and severe facial eye swelling or
damage make it impossible to test the verbal and eye
response.
- In these circumstance , the score is given as 1 with a
modifier attached (e.g E1C , Where “C”= closed , or
‘V1t “ where t = tube ). Often the 1 is left out , so the
scale reads Ec or vt .
- The GCS has limited applicability to children especially
below the age of 36 months (where the verbal
performance of even a healthy child would be
expected to be poor).