The Glasgow Coma Scale (GCS) is a neurological scale which aims to give a reliable, objective way of recording the conscious state of a person. The GCS is a helpful way of recording the level of consciousness following brain injury from initial measurement through to subsequent measurements during the early stages of recovery. It was published in 1974 by Graham Teasdale and Bryan J. Jennet, Professors of Neurosurgery at the University of Glasgow’s Institute of Neurological Sciences.
The method of using the Glasgow Coma Scale is best understood by watching ‘Glasgow Coma Scale – A Practical Demonstration’. Kindly reproduced with permission of Woodend productions 2011. (Please ensure your web browser is up to date in order to play this video. Please click on the screen to start the video).
The scale is composed of three tests: the Eye Opening Response, the Verbal Response and the Motor Response. The patient’s level of consciousness is evaluated in response to three parameters:
- Spontaneous response e.g. spontaneous eye opening or speech.
- Response to a verbal instruction.
- Response to a painful stimulus i.e. supraorbital or finger nail pressure
N.B. Account must be taken of other injuries that may interfere with the person’s ability to respond (e.g. eye, mouth injuries, paralysis of limbs).
The scale is scored between 3/15 to 15/15. A score of 3 is indicative of a deep level of unconsciousness and 15 means that the person is fully alert. These scores are used to predict early mortality and longer term outcome in patients following Acquired Brain Injury. The GCS is one of the measures used to assess severity of injury.
| Feature | Scale
Responses |
Score
Notation |
| Eye opening | Spontaneous
To speech To pain None |
4
3 2 1 |
| Verbal response | Orientated
Confused conversation Words (inappropriate) Sounds (incomprehensible) None |
5
4 3 2 1 |
| Best motor response | Obeys commands
Localises pain Flexion-normal Flexion-abnormal Extend None |
6
5 4 3 2 1 |
| TOTAL GCS SCORE | 3/15-15/15 |