Head Injury (cont.)
What is the Glasgow Coma Scale?
The Glasgow Coma Scale was developed to provide health care practitioners a
simple way of measuring the depth of coma based upon observations of eye
opening, speech, and movement. Patients in the deepest level of coma:
- do not
respond with any body movement to pain,
- do not have any speech, and
- do not open
their eyes.
Those in lighter comas may offer some response, to the point they may
even seem wake, yet meet the criteria of coma because they do not respond to
their environment.
| Glasgow Coma Scale
|
| Eye Opening |
|
| Spontaneous |
4 |
| To loud voice |
3 |
| To pain |
2 |
| None |
1 |
| |
| Verbal Response |
|
| Oriented |
5 |
| Confused, Disoriented |
4 |
| Inappropriate words |
3 |
| Incomprehensible words |
2 |
| None |
1 |
| |
| Motor Response |
|
| Obeys commands |
6 |
| Localizes pain |
5 |
| Withdraws from pain |
4 |
| Abnormal flexion posturing |
3 |
| Extensor posturing |
2 |
| None |
1 |
An awake person has a Glasgow Coma Scale of 15, while a
person who is dead would have a score of 3. The abnormal motor responses of
flexion and extension describe arm and leg movement when a painful stimulus is
applied. The term "decorticate" means that the cortex of the brain, the part
that deals with movement, sensation, and thinking, is not working. "Decerebrate"
means that the cerebrum, the cortex, and the brain stem that controls basic
bodily functions like breathing and heart beat, is not working.
The scale is used as part of the initial evaluation of a patient, but does not assist in making the diagnosis as to the cause of coma. Since it "scores" the level of coma, the GCS can be used as a standard method for any health
care practitioner to assess change in patient status.
Next: When should I contact a doctor about a head injury? »
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