Glasgow Coma Scale

First described in 1974, this renowned scale provides an assessment of coma and impaired consciousness. Results of the assessment are used to guide initial decision making about treatment and monitor trends in patient responsiveness. Used by physicians and clinicians worldwide, the scale is a method of communicating the consciousness of patients with acute brain injury. The scale assesses visual, verbal, stimulation, and motor responses to determine the extent of a coma. Used widely in acute and postacute settings, the scale has become a powerful tool in deciphering the degree of a person's brain injury.

Eye Opening	E
spontaneous	4
to speech	3
to pain	2
no response	1
Best Motor Response	M
To Verbal Command:
obeys	6
To Painful Stimulus:
localizes pain	5
flexion-withdrawal	4
flexion-abnormal	3
extension	2
no response	1
Best Verbal Response	V
oriented and converses	5
disoriented and converses	4
inappropriate words	3
incomprehensible sounds	2
no response	1

E + M + V = 3 to 15

90% less than or equal to 8 are in coma
Greater than or equal to 9 not in coma
8 is the critical score
Less than or equal to 8 at 6 hours - 50% die
9-12 = moderate severity
Greater than or equal to 13 = minor injury

Coma is defined as: (1) not opening eyes, (2) not obeying commands, and (3) not uttering understandable words.