( Figure 1 ) Changes in motor response are the predominant factor in more severely impaired patients, whereas eye and verbal are more useful in lesser degrees. The information gained from the three components of the Scale varies across the spectrum of responsiveness. Serial Glasgow Coma Scale assessments are also critical in monitoring the clinical course of a patient and guiding changes in management. Decisions in less severely impaired patients include the need for neuroimaging, admission for observation or discharge. Decisions in more severely impaired patients include emergent management such as securing the airway and triage to determine patient transfer. Īssessment of responsiveness with the Glasgow Coma Scale is widely used to guide early management of patients with a head injury or other kind of acute brain injury. The Glasgow Coma Scale is a required component of the NIH Common Data Elements for studies of head injury and the ICD 11 revision and is used in more than 75 countries. These cover patients of all ages, including preverbal children. Additionally, the World Federation of Neurosurgical Societies (WFNS) used it in its scale for grading patients with subarachnoid hemorrhage in 1988, The Glasgow Coma Scale and its total score have since been incorporated in numerous clinical guidelines and scoring systems for victims of trauma or critical illness.
The use of the Glasgow Coma Scale became widespread in the 1980s when the first edition of the Advanced Trauma and Life Support recommended its use in all trauma patients. For example, a score of 10 might be expressed as GCS10 = E3V4M3.
The score expression is the sum of the scores as well as the individual elements. The findings in each component of the scale can aggregate into a total Glasgow Coma Score which gives a less detailed description but can provide a useful ‘shorthand’ summary of the overall severity.
Reporting each of these separately provides a clear, communicable picture of a patient’s state. The scale assesses patients according to three aspects of responsiveness: eye-opening, motor, and verbal responses. The Glasgow Coma Scale (GCS) is used to objectively describe the extent of impaired consciousness in all types of acute medical and trauma patients. The Glasgow Coma Scale was first published in 1974 at the University of Glasgow by neurosurgery professors Graham Teasdale and Bryan Jennett.
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