Glasgow Coma Scale

The Glasgow Coma Scale ( GCS ), also Glasgow Coma Scale or Glasgow Scale for short , is a simple scale for assessing a disturbance of consciousness . It is often used in intensive care medicine - especially after a traumatic brain injury (trauma) - but it can also be used to quantify general disorders of consciousness. Here it should be noted that recommendations about to be drawn intense medical consequences (such as endotracheal intubation at values less than 9) only for patients with traumatic brain injury, in the context of a polytrauma, are scientifically validated.

This evaluation scheme, widely used in emergency medicine and emergency medical services , to describe the state of consciousness as a correlate of the function of the central nervous system was developed in 1974 by Graham Teasdale and Bryan J. Jennett, two neurosurgeons at the University of Glasgow ( Scotland ).

There are three categories for which points are awarded:

• Eye opening (1–4 points)
• Best verbal response (1-5 points)
• Best motor response (1-6 points)

Points are awarded separately for each category and then added up. The maximum number of points is 15 (with full consciousness ), the minimum 3 points (with deep coma ). With 8 or fewer points, severe brain dysfunction and there is a risk of life-threatening respiratory disorders, so that securing the airway through endotracheal intubation must be considered.

The Glasgow Coma Scale is used, for example, to assess the severity of a traumatic brain injury , but also in general in neurology . It is also part of other scoring systems (German evaluation systems), for example the Mainz Emergency Evaluation Score or the SAPS Score .

Glasgow Coma Scale for Adults

Points	open eyes	Verbal communication	Motor response
6 points	-	-	obeys requests
5 points	-	conversational, oriented	targeted defense against pain
4 points	spontaneous	conversational, disoriented	untargeted defense against pain
3 points	on demand	incoherent words	Flexion synergisms (abnormal flexion) in response to pain stimuli
2 points	on painful stimulus	unintelligible sounds	stretch synergisms on pain stimulus
1 point	no reaction	no verbal response	no response to pain stimulus

Example of point calculation: If a person can open their eyes when prompted, is conversational / oriented and shows stretch synergisms in response to a pain stimulus, they receive 3 + 5 + 2 = 10 points on the GCS.

interpretation

The Glasgow Coma Scale can then be used to estimate the degree of traumatic brain injury :

• light SHT : GCS 15-13
• moderate SHT : GCS 12–9
• severe TBI : GCS 8–3

restrictions

The use of the Glasgow Coma Scale is of limited use in children under the age of 36 months due to the lack of verbal communication skills. That is why the Pediatric Glasgow Coma Scale was developed for younger children . Even with disoriented people in need of care, the GCS is only of limited information. Apart from the Glasgow Coma Score, the decision about the treatment of trauma patients also depends on clinical symptoms and findings (CT, MRI, etc.).

See also

• AVPU

Individual evidence

1. ↑ G. Teasdale, B. Jennett: Assessment of coma and impaired consciousness. A practical scale. In: Lancet , Volume 2, 1974, pp. 81-84. PMID 4136544 .
2. ↑ Walied Abdulla: Interdisciplinary Intensive Care Medicine. Urban & Fischer, Munich a. a. 1999, ISBN 3-437-41410-0 , p. 467.
3. ↑ Guidelines for Diagnostics and Therapy in Neurology. 4th edition. Georg Thieme Verlag, Stuttgart 2008, ISBN 978-3-13-132414-6 , p. 654 ff.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !