From the Guidelines
The Glasgow Coma Scale (GCS) score is a neurological scale used to assess the severity of traumatic brain injury, ranging from 3 to 15, with higher scores indicating better neurological function, as recommended by the most recent study 1. The GCS score is based on three components: eye response, verbal response, and motor response, with each component having a specific score range [ 1, 1 ].
- The eye response component scores range from 1 to 4, with 1 indicating no eye opening and 4 indicating spontaneous eye opening.
- The verbal response component scores range from 1 to 5, with 1 indicating no verbal response and 5 indicating the patient is oriented and converses normally.
- The motor response component scores range from 1 to 6, with 1 indicating no motor response and 6 indicating the patient obeys commands. The GCS score has been widely used to assess the severity of traumatic brain injury and to predict patient outcomes, with lower scores indicating more severe injury and poorer outcomes [ 1, 1 ]. However, the use of a single GCS determination has limitations, and serial GCS scores are more valuable in assessing patient progress and predicting outcomes [ 1 ]. The most recent study 1 recommends that a GCS score of 14 or 15 be used to define mild traumatic brain injury, while a score of 13 is considered to indicate a higher or moderate risk of injury. It is essential to use the GCS score in conjunction with other clinical assessments and imaging studies to accurately diagnose and manage traumatic brain injury [ 1, 1, 1 ].
From the Research
Definition of Glasgow Coma Scale (GCS) Score
The Glasgow Coma Scale (GCS) score is a tool used to assess the level of consciousness in patients with brain injury or other conditions that affect the brain [(2,3,4,5,6)]. It consists of three components:
- Ocular response: evaluates the patient's ability to open their eyes
- Verbal response: assesses the patient's ability to speak and respond to verbal commands
- Motor response: evaluates the patient's ability to move and respond to physical stimuli
Components and Scoring
The GCS score is calculated by adding the scores from each of the three components, with a total score ranging from 3 to 15 [(2,5)]. A higher score indicates a higher level of consciousness. The scale is used to:
- Assess the severity of brain injury or illness
- Monitor changes in the patient's level of consciousness over time
- Communicate information about the patient's condition to other healthcare professionals
Uses and Limitations
The GCS score is widely used in clinical practice to assess patients with traumatic brain injury [(2,3,5)] and other conditions that affect the brain. However, its use in patients without traumatic brain injury is not recommended 3, and it may not be suitable for patients who are sedated, paralyzed, or intubated 2. Alternative scales, such as the Full Outline of UnResponsiveness (FOUR) Score, have been developed to address some of the limitations of the GCS 4.