its a slide describing the use of scale with a person with head trauma.

1. GLASGOW COMA SCALE
PRESENTATION
BY: CIZMAN M.Q
AKA JET BLACK/CIZMAN BOZKIL
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2. Introduction to the GCS
• Neurological assessment tool
• Published in 1974 by Jennett and Teasdale
• Aim of the tool: determining the severity of a
patients’ brain dysfunction
• Originally intended for post head injury patients, now a
tool for all acute medical and trauma patients.
• It is widely used to assess level of consciousness in a
variety of clinical settings and is a recommended
observation tool in all patients with head injuries.
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3. Scoring system
• A patients assessment will result in a score
between three; no response and fifteen; fully
alert and responsive.
• The score out of 15 is derived from the three
tests on eye opening, verbal response and
motor response. Alongside this, pupil
response, neurological limb response and
basic vital signs are also recorded.
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4. How is the score composed?
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5. How are the components assessed?
• Eyes Opening:
– Score 4: eyes open spontaneously;
– Score 3: eyes open to speech;
– Score 2: eyes open in response to pain only,
– Score 1: eyes do not open to verbal or painful
stimuli.
– ‘C’ is recorded for patients unable to open eyes
due to for example swelling
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6. How are the components assessed?
• Verbal Response:
– Score 5: orientated; must be able to tell you their full
name, the place in which they are and the date. If the
patient doesn’t know any of these it is assumed they are
confused.
– Score 4: confused; not able to answer orientation
questions
– Score 3: inappropriate words; swearing, aggression,
unrelated words to the questions being asked
– Score 2: incomprehensible sounds;
– Score 1: no verbal response.
– ‘D’ is marked for patients who are dysphasic (unable to
speak coherently. ‘T’ is marked for those with a
tracheostomy5/6/2016 11:30 AM 6

7. How are the components assessed?
Best Motor Response:
• Score 6: obeys commands. The patient can perform two
different movements; primitive reflexes should not be tested
• Score 5: localises to central pain. The patient does not
respond to a verbal stimulus but purposely moves an arm to
remove the cause of a central painful stimulus
• Score 4: normal flexion. The patient flexes or bends the arm
towards the source of the pain but fails to locate the source of
the pain (no wrist rotation)
• Score 3: abnormal flexion to pain
• Score 2: extension to pain
• Score 1: no response to painful stimuli.
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8. Classification of Brain Injury
According to Glasgow Coma Scale
(GCS)
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MILD
GCS 13-15
MODERATE
GCS 9-12
SEVERE
GCS 3-8

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10. Causes of a decreased conscious level
Hypoxaemia
Hypotension
Hypercapnia
Hypoglycaemia
Drugs (sedatives,opiates,
overdoses,alcohol)
Seizures
Head injury
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Intracranial
haemorrhage
Cerebral infarction
Intracranial infection
Hypothermia
Hyperthermia
Hypothyroidism
Hepatic
encephalopathy

11. Early Signs & Symptoms of Raised ICP
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• Deterioration in level of consciousness
(LOC)
• Confusion
• Restlessness
• Lethargy
• Headache
• Pupillary dysfunction
• Motor & sensory deficits
• Cranial nerve palsy

12. Transient Signs & Symptoms of Raised ICP
• Decreased LOC
• Pupil abnormalities
• Visual disturbance
• Motor dysfunction
• Headache & vomiting
• Aphasia
• Changes in respiratory pattern
• Changes in vital signs
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13. Late Signs & Symptoms of Raised ICP
• Continued deterioration in level of
consciousness
• Hemiplegia, decortication & decerebration
• Alteration in vital signs
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14. Summary
• A decreased level of consciousness is common in acute
illness
• Hypoxaemia,hypotension, hypoglycaemia are common
causes of coma
• A decreased consciousness level may cause airway
obstruction and loss of protective airway reflexes
• Failure to identify early signs and symptoms of raised
intracranial pressure puts the patient at great risk, and
opportunity for intervention may be lost
• Potential if untreated a respiratory or cardiac arrest
• Treatment of a deteriorating consciousness is focused on
care of the airway, breathing, circulation disability and
exposure
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15. Thank you for
listening 
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