The Glasgow Coma Scale (GCS) for first aiders
As the name suggests, the scale was first designed in Glasgow for patients who had suffered a head injury. It is now used across the world by emergency medical staff and first aiders to assess a patients level of consciousness.
The Glasgow Coma Scale contains three measurements: Eyes, Verbal and Motor. Each measurement is assigned a score and the GCS is the total of the three scores combined. The minimum GCS score is 3 (completely unconscious) and the maximum is 15 (fully alert).
The following table lists the individual components of the Glasgow Coma Scale and how the individual measurements are scored.
|Open to speech||3|
|Open to painful stimulus||2|
|No response (no eye opening)||1|
|No response (silent)||1|
|Points (localises) to pain||5|
|Withdraws from pain||4|
|Bends limbs in response to pain (flexion)||3|
|Straighten limbs in response to pain (extension)||2|
A GCS of less than 8 is generally considered a serious medical emergency due to problems with the airway. Patients who have a GCS less than 8 are unlikely to be able to protect their airway and are at risk of hypoxia (lack of oxygen).
When recording a Glasgow Coma Scale score you should identify the individual components as well as the overall score. e.g: E4 S4 M6 = GCS 14
It is important to remember that GCS scores can fluctuate minute-by-minute, especially in critically unwell patients.
Issues with the Glasgow Coma Scale
The Glasgow Coma Scale does have problems however. It can be quite difficult to learn and also people can interpret the scoring system in different ways.
In addition, various factors such as alcohol & drugs can ‘mask’ a casualties true level of consciousness, especially in a head injury situation. However despite this the Glasgow Coma Scale is still widely used by emergency medical services and hospitals across the world.
Glasgow Coma Scale video
The GCS can be a very complicated scale to use. This entertaining video explains the GCS in a slightly different way and may be more memorable than a boring table!
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