This Glasgow Coma Scale (GCS) Calculator allows you to assess the level of consciousness following traumatic brain injury based on eye, verbal and motor response. You can read more about this universally established method and its interpretation below the form.
The Glasgow coma scale/score GCS Calculator
This is a method published by Graham Teasdale and Bryan J. Jennett, professors of neurosurgery at the University of Glasgow's Institute of Neurological Sciences in 1974 and is now universally established as a way of observing and quantifying the conscious state of someone who suffers from brain injury.
There are three types of response that are monitored:
| Glasgow Coma Scale (GCS) | ||
| Types of response | Degrees | Points |
| Eye opening | spontaneous opening | 4 |
| eye opening to auditive stimulus e.g. speech | 3 | |
| eye opening to pain stimulus e.g. squeezing the top of a finger | 2 | |
| no eye opening | 1 | |
| Verbal response | oriented responses with the patient being coherent and answering appropriately | 5 |
| confused answering with the patient disoriented | 4 | |
| inappropriate words with the patient saying words but not sentences | 3 | |
| incomprehensible sounds | 2 | |
| no verbal response | 1 | |
| Motor response | conscious obeying of the motor commands given | 6 |
| movement towards pressure/ pain stimulus | 5 | |
| withdrawal from pain/ pressure stimulus | 4 | |
| flexor reaction | 3 | |
| extensor reaction | 2 | |
| no motor response | 1 | |
This Glasgow coma scale calculator is used both as a method to assess the current state and to predict the progression of the condition because observations are to be taken and registered at certain time intervals.
Observations are to be recorded every half hour until GCS reaches 15. Once this value is achieved, the observations should be taken half hourly in the first 2 hours, 1 per hour for the following 4 hours and then 2 hourly. If the state deteriorates, the half hourly observation should be re- established.
This method is used by clinicians and medical staff in ER (emergency rooms) and ICU (intensive care units) in both trauma and non trauma presentations.
It is very important to follow the patient trend through frequent observations because then the correlation with outcome and severity increases. It is recommended to be used repetitively to chart changes in mental status and duration of coma.
GCS is not only a tool to assess and score mental status but can also offer clinical support in certain decisions such as a GCS of 8 or below might require intubation. However, it is often underlined that this should not be used as a quantitative method, on its own as a mean to monitor brain injury.
GCS Interpretation
As explained above, there are three types of response that are assessed, each with its own choices and a scoring system with points. Eye opening has a maximum of 4 points, verbal response totalizes a maximum of 5 points while motor response has a maximum of 6 points.
The lowest score for each category is 1, therefore the overall lowest is 3 with no eye opening, no verbalization and no response to pain stimuli. The highest score, with the highest level of consciousness is 15.
| Brain injury classification | |
| GCS: 3 - 8 | Severe injury |
| GCS: 9 - 12 | Moderate injury |
| GCS: 13 -15 | Minor injury |
■ Severe brain injury – results in long term cognitive, physical impairment accompanied by emotional, behavioral changes, diagnosed through imagistic means and GCS.
■ Moderate brain injury – results in long term cognitive and physical impairment with the changes appearing shown in CT scans or MRIs.
■ Minor brain injury – results in temporary or permanent neurological effects, in some cases with no imagistic (CT scan, MRI) clear evidence of the brain damage.
References
1) Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974,2:81-84.
2) The Glasgow Structured Approach to Assessment of the GLASGOW COMA SCALE.
16 Jun, 2015