GCS = Glasgow Coma Scale

Do you want your coma scale to be high or low?

The Glasgow Coma Scale is named after two professors of neurosurgery at the University of Glasgow (Glasgow = scenic Scottish city sitting on the River Clyde). We have them to thank for mnemonics like "eight means intubate," AVPU (alert, voice, pain, unresponsive), et cetera.

The Glasgow Coma Scale, a quick assessment of a patient's level of consciousness, can be broken down into three categories: best eye opening, best speech, and best motor response.

4 points: eyes open, tracking your behind
3 points: eyes open when you say, "Look, squirrel!"
2 points: eyes open if you stick the biggest syringe ever into a large muscle
1 point: no response regardless of anything and everything.

"Mr. D, do you have any medication allergies?"
5 points: "Why, yes, I do. Tylenol, Motrin, Toradol, and Morphine. The only thing that works for me is Dilaudid."
4 points: "Is this the planet Mars? My spaceship is forever gone."
3 points: Cat sharpie long long Jupiter oatmeal.
2 points: mmmmm ehhhhhhh mmmmm...
1 point: [silence]

6 points: runs away from you at the sight of the big honking needle
5 points: tries to take arm back upon feeling jab
4 points: arm flexes in response to being stabbed by needle
3 points: decorticate posturing
kind of like this, but lying down in bed, and your patient doesn't look like this.

2 points: decerebrate
Like this but stiffer, and your patient doesn't look like this, either.

1 point: no motion

A total of 15 points is what most of us score, maybe minus a point or two after the semester has ended and baseline functioning (beyond feeding & caring for your children/yourself) is no longer required. 9-12 points shows moderate brain injury; 3-8 points means severe damage.

So yes, you want your coma scale to be high!


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