Glasgow Coma Scale

The Glasgow Coma Scale (GCS) is a neurological scale which aims to give a reliable and objective way of recording the state of a person's consciousness for initial as well as subsequent assessment. A person is assessed against the criteria of the scale, and the resulting points give a person's score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (more widely used modified or revised scale). The Glasgow Coma Scale (GCS) is a neurological scale which aims to give a reliable and objective way of recording the state of a person's consciousness for initial as well as subsequent assessment. A person is assessed against the criteria of the scale, and the resulting points give a person's score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (more widely used modified or revised scale). GCS was initially used to assess a person's level of consciousness after a head injury, and the scale is now used by emergency medical services, nurses, and physicians as being applicable to all acute medical and trauma patients. In hospitals, it is also used in monitoring patients in intensive care units. The scale was published in 1974 by Graham Teasdale and Bryan J. Jennett, both professors of neurosurgery at the University of Glasgow's Institute of Neurological Sciences at the city's Southern General Hospital. GCS is used as part of several ICU scoring systems, including APACHE II, SAPS II, and SOFA, to assess the status of the central nervous system. The initial indication for use of the GCS was serial assessments of people with traumatic brain injury and coma for at least six hours in the neurosurgical ICU setting, though it is commonly used throughout hospital departments. The similar Rancho Los Amigos Scale, is used to assess the recovery of traumatic brain injury. GCS was updated following a review of the helpfulness and usefulness of the scale from clinicians. It was decided that several things required updating, like the Eye Response element, meaning that instead of responding to 'Painful Stimuli' being regarded as a 2, a person that opens their eyes in response to pressure is now considered a 2 in the Eye Response element. Note that a motor response in any limb is acceptable.The scale is composed of three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (graded 1 in each element) is 3 (deep coma or death), while the highest is 15 (fully awake person).