It’s (Almost) Fun Fact Friday!

Fact: A person’s level of consciousness is measurable

First published in 1974, the Glasgow Coma Scale was initially used to record the level of consciousness in patients who had experienced traumatic brain injury. Since then it has been revised and can be applied to all trauma patients.

Does anyone remember those fun quizzes in the back of magazines that would usually determine what colour your aura is or what kind of kisser you are based on a score calculated by how you answered the questions? No?

Well, the GCS is kind of like that…

A patient can score between 3 and 15 on the scale; 3 indicates a deep unconsciousness and/or death (not good) and 15 indicates a fully awake person (good). There are three different categories measured within the scale: Eye Response, Verbal Response, and Motor Response. The individual sum from each category is considered in addition to the total of all three. Here’s the score criteria:

Eye Response (E)

1. No eye opening

2. No eye opening in response to pain stimulus

3. Eye opening to speech

4. Eyes opening spontaneously

Verbal Response (V)

1. No verbal response

2. Incomprehensible sound (such as moaning but no words)

3. Inappropriate words (random, articulated words; no sentences/conversation)

4. Confused (responds to questions, but is disoriented/confused)

5. Oriented (coherent, appropriate responses to questions such as name, age, etc.)

Motor Response (M)

1. No motor response

2. Decerebrate posturing accentuated by pain (extensor response)

3. Decorticate posturing accentuated by pain (flexor response)

4. Withdrawal from pain

5. Localizes to pain (purposeful movements towards painful stimuli)

6. Obeys commands

Quick example: A patient is opening their eyes when spoken to, but are unable to speak or make noise and have no motor response. Their score would be recorded as

“GCS 5= E3 V1 M1”; severe. Try giving yourself, or someone near you a GCS score!

Generally, brain injuries are classified as

• Severe, GCS < 8-9

• Moderate, GCS 8/9-12

• Minor, GCS ≥ 13

It should be noted that the use of this scale has limited applicability to children for various reasons, and special scores are given to patients with severe facial/eye damage which makes it difficult to test eye or verbal response. And I’m sure the use of this scale is actually more complicated than it might seem.

That was a lot of information, so let’s end with something fun!