The Glasgow Coma Scale (GCS) for first aiders

GCSThe Glasgow Coma Scale (commonly shortened to GCS) is a measurement of a patients level of consciousness, ie how awake the patient is. 

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 (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.

Observation Response Score
Eyes Open spontaneously 4
Open to speech 3
Open to painful stimulus 2
No response (no eye opening) 1
     
Verbal Responds sensibly  5
Confused 4
Inappropriate words 3
Incomprehensible sounds 2
No response (silent) 1
     
Motor Obeys commands 6
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
No response 1

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 pocket guide

Remembering all the details of the Glasgow Coma Scale can be challenging, especially when dealing with a stressful situation such as a medical or trauma emergency. We recommend buying an aide memoir to help you remember essential information such as how to calculate a GCS.

These pocket cards are a great way for first aiders, first responders, EMTs and paramedics to access information whilst in the field. 

The cards are reasonably priced and available from Amazon. 

 

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! 

Want to learn more?

Want to learn more about the Glasgow Coma Scale and other first aid tools? Why not sign up to one of our FREE online first aid courses!

John Furst

JOHN FURST is an experienced emergency medical technician and qualified first aid and CPR instructor. John is passionate about first aid and believes everyone should have the skills and confidence to take action in an emergency situation.

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5 Responses

  1. Thanks for sharing this important information here with us.

  2. cpefley says:

    Never heard of the Glasgow Coma Scale, but that is a really great way to determine whether or not a head injury is severe before a CT scan can be performed. Thanks for sharing!

  3. theshaynee says:

    I didn’t know there were different levels to a coma.
    It makes complete sense though because it’s all based on how bad or intense the injury was.

  4. david rotbasean says:

    cool

  5. Francino says:

    nice, especially the dancing part… but moderate injury is 9 to 12 and not 8 to 12, and mild is 13 to 15, not 12 to 15, please amend that… 😉

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