A junior colleague calls you about a patient on one of the elderly wards. They have fallen over and sustained a head injury. They tell you that the patient is orientated in time, place, and person, is opening their eyes when spoken to, and obeys commands such as put you finger to your nose. What is the patients Glasgow Coma Scale score?
Their score is E3 V5 M6 = 14
Their score is E3 V5 M6 = 14
Glasgow Coma Scale
The Glasgow Coma Scale was designed to quantify the depth of coma and impaired consciousness. It is an important scale to be ware of as a psychiatrist as we are frequently expected to assess patients with altered levels of consciousness.
For each area the patients best response is matched to the criteria for scoring. These score are then combined to give a final result out of 15.
Scores range from 3 (deep coma) to 15 (normal). Impaired consciousness is rated as mild (13-15), moderate (9-12), and severe (3-8).
Scoring Guide
| Assessed Behaviour | Criteria for scoring |
|---|---|
| Eye opening response | 4 Spontaneous opening |
| 3 Opens to verbal stimuli | |
| 2 Opens to pain | |
| 1 No response | |
| Verbal response | 5 Orientated |
| 4 Confused conversation | |
| 3 Inappropriate words | |
| 2 Incoherent | |
| 1 No response | |
| Motor response | 6 Obeys commands |
| 5 Purposeful movement to painful stimuli | |
| 4 Withdraws in response to pain | |
| 3 Flexion in response to pain (decorticate posturing) | |
| 2 Extension in response to pain (decerebrate posturing) | |
| 1 No response |
