Glasgow Coma Scale (GCS)

3 things to look for

eyes

verbal

motor

eyes 4

spontaneous

open on its own

eyes 3

to verbal

open when talked to

eyes 2

to pain

eyes 1

no eye opening

verbal 5

oriented

verbal 4

confused

can converse

verbal 3

inappropriate words

clear words but no meaningful sentence

verbal 2

incomprehensible sounds (grunting, etc)

verbal 1

nonverbal

motor 6

able to follow simple commands

motor 5

localizes pain

purposefully reaches towards/pushes away from painful stimulus

motor 4

withdraws from pain

pulls away from pain but doesn’t try to stop it

motor 3

decorticate posturing

arms bend inward toward chest

motor 2

decerebrate posturing

arms straighten/extend outward

motor 1

no response

A patient who opens his eyes in response to pain, makes no verbal response, but withdraws from pain has a Glasgow Coma Score of

7

A GSC of 13-15 wound indicate _______ traumatic brain injury

mild

A GSC of 9-12 would indicate ________ traumatic brain injury

moderate

A GSC of 3-8 would indicate _______ traumatic brain injury

severe

GCS Score

Eye opening: none
Sounds: none
Motor Response: none

3

GCS Score

Eye opening: to pressure
Sounds: none
Motor Response: none

4

GCS Score

Eye opening: to sound
Sounds: sounds
Motor Response: none

6

GCS Score

Eye opening: spontaneous
Sounds: confused
Motor Response: withdrawal

12

GCS Score

Eye opening: to pressure
Sounds: words
Motor Response: abnormal flexion

8

GCS Score

Eye opening: to sound
Sounds: confused
Motor Response: withdrawal

11

GCS Score

Eye opening: spontaneous
Sounds: confused
Motor Response: obeys commands

14

You are called to see a patient who has fallen through a plate glass door. As you approach the patient you observe that their eyes are extremely swollen and they are unable to open them. How would you record the eye component of the scale?

A. None
B. To pain
C. Eyes not testable (NT)

C. Eyes not testable (NT)

If you were told by a colleague that their assessment of a patient's Glasgow Coma Scale was E2, V3, M5, how would you interpret this?

A. The patient's eyes open to sound, they are orientated are able to obey commands
B. The patient's eyes open to pressure, they can utter some words but do not form sentences, and they are able to localise to trapezius pinch.
C. The patient's eyes open spontaneously; they are orientated and able to obey commands

B. The patient's eyes open to pressure, they can utter some words but do not form sentences, and they are able to localise to trapezius pinch

You are assessing the GCS score in a 90-year-old trauma patient. Your patient's eyes open in response to speech, but is nonverbal and only appears to make localizing, purposeful movement towards painful stimuli. What's your best estimate of this patient's GCS score?

A. 13
B. 7
C. 9
D. 11

C. 9

What is the expected Glasgow coma score of a patient who opens their eyes in response to pain, makes incomprehensible sounds, and has abnormal posturing?

A. Less than 5
B. 5 to 8
C. 8 to 11
D. 12 to 15

B: 5-8

You are assessing Glascow Coma Scale on your patient. She opens her eyes and pulls away when she is pinched, and speaks only in garble sounds. Your patient GCS score is:

A. 3
B. 15
C. 11
D. 8

D. 8

When you apply a sternal rub, the patient extends her arms and legs, but shows no other response. What is her GCS ?

4

A 56 year old male is found unconscious in bed. He does not respond to verbal or painful stimulus and has decorticate posturing. What is his GCS ?

5

A 30 year old male was found on the sidewalk outside a homeless shelter. When you apply painful stimuli, he opens his eyes, tells you to go away, and then pushes your hand away. What is his GCS?

12

A 37 year old female is intoxicated and has fractured her leg. When you apply a splint, she looks at you and withdraws her leg then grunts in pain. What is her GCS?

8

An 81 year old male is pulseless and apneic. He is lying supine in bed . What is his GCS ?

3

An 85 year old male in a nursing home is walking around his room and greets you when you enter. He speaks clearly but his answers are confusing and rambling. What is his GCS ?

14

A 6 year old male fell 6 feet from a tree. He is awake and has the ability to move all of his extremities. When you ask what happened, he tells you that he "fell" and then begins to tell you about his pet dog. What is his GCS?

14

A 28 year old female with a closed head injury moans and bends her arms towards her chest. She points her toes forward when you attempt to splint upper extremity fracture. What is her GCS?

6

A 64 year old male looks at you when you speak to him. When you ask him the date, he says, "Tinkerbell." He has left-sided weakness when he grips your fingers. What is his GCS?

13

A 21 year old male is extremely intoxicated. When you attempt to insert a nasal airway he slaps your hand away, curses at you, and then sits up. When you remove the airway, he lies back down on the stretcher. What is his GCS?

11

A 44 year old female fell off a roof. She answers your commands with what sounds like a moan. When you pinch her trapezius, her eyes do not open but she moves her legs. What is her GCS?

7

A 17 year old male overdosed on narcotics. He looks around with an unfocused gaze, mumbles when you ask him questions, and pulls away from painful stimulus. What is his GCS ?

10

A 24 year old female overdosed on an unknown substance. She is staring off into space, writhing. and babbling. When you apply painful stimulus, she cries out incomprehensibly but does not pull away. What is her GCS ?

9

A 23 year old female eyes are open. She is speaking normally and is able to answer your questions. She shows two fingers when asked. What is her GCS?

15

You find a 31 year old male with eyes closed. He groans when pinched on the shoulder and attempts to push away your hand. What is his GCS?

8

You arrive to find a young male eyes open and anxiously looking around. He can not answer any questions at all. You pinch him and he groans, but you do not recognizable any of the words. He cannot follow commands and when touched, he grabs your hand and will not easily let go. What is his GCS?

11

Your patient does not open her eyes. She makes no sounds and withdraws from pain. What is her GCS?

6

Your patient only opens his eyes to pain, moans and withdraws. What is his GCS?

8

Your patient only opens his eyes to pain, makes no sounds and stiffens and extends his extremities. What is his GCS?

5

Your patient only opens his eyes to pain, curses and extends his extremities. What is his GCS?

7

Your patient opens his eyes spontaneously, doesn't know his name or location but follows commands. What is his GCS?

14

Your patient opens his eyes spontaneously, know his name and location and follows commands. What is his GCS?

15