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Glasgow Coma Scale

Nursing Knowledge

Glasgow Coma Scale

The Glasgow Coma Scale (GCS) is a widely used tool for assessing the level of consciousness in clients with neurological conditions. It is an essential tool for nurses who need to monitor and evaluate the neurological status of their clients. The GCS score can range from 3 to 15, with lower scores indicating more severe neurological concerns. Continue reading to learn how to use and interpret the scale.
Last updated: October 9, 2024

Table of contents

What is the Glasgow Coma Scale (GCS)?

The Glasgow Coma Scale (GCS) is a reliable approach to assess an individual’s neurological state. It measures the level of consciousness based on eye-opening, verbal response, and motor response. Each of these aspects is given a score, and these scores are then added together to give a total score.

What age range can the GCS scoring scale be used for?

The GCS scoring scale can be used for clients aged 3+.

What is the range of GCS scores?

The GCS score can range from 3 to 15, with 3 being the least neurologically responsive and 15 being the most neurologically responsive.

Breakdown:

  • Eye-opening: 1–4 points (4 being best)
  • Verbal response: 1–5 points (5 being best)
  • Motor response: 1–6 points (6 being best)

How do you use the Glasgow coma scale?

To use the GCS, observe the client for eye-opening, language, and body movements. If a client is unable to be tested due to medications, paralysis, intubation, or similar factors, score that section as NT (Not Testable). Calculate the final GCS score by adding corresponding values for eye-opening, verbal responses, and motor responses.

How do you calculate a GCS score?

To calculate the final GCS score, add corresponding values for eye-opening, verbal responses, and motor responses.

What are the three categories of neurological concerns based on GCS scores?

The three categories of neurological concerns based on GCS scores are mild (13–14), moderate (9–12), and severe (3–8).

What is a normal Glasgow coma scale score? 

A normal GCS score, indicating full neurological health, is 15. However, a GCS score of 13 or above is generally considered to be within the normal range. Scores below this may suggest a varying degree of neurological impairment or injury.

What is decorticate vs decerebrate posturing?

Decorticate and decerebrate posturing are signs of severe brain damage, often related to conditions like traumatic brain injury, brain tumor, or brain hemorrhage.

  • Decorticate posturing: This posture is characterized by the person’s arms being adducted and flexed with the hands clenched and held to the chest while the legs are stiffly extended and internally rotated. This indicates damage to the cerebral hemispheres, the internal capsule, the thalamus, or the midbrain.
  • Decerebrate posturing: This posture is characterized by stiffly extended arms, held close to the body, and wrists and fingers flexed away from the body. The legs are also extended and rotated inward. The teeth are clenched, and the neck is extended. This posture indicates damage to the brainstem.

In terms of the GCS, decerebrate and decorticate postures are part of the motor response component. A client displaying decorticate posturing would score 3 in the motor response section, while a client displaying decerebrate posturing would score 2, indicating more severe damage.

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Glasgow Coma Scale

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The Glasgow Coma Scale is a neurological assessment tool used to determine a patient’s motor and verbal responses and their level of consciousness.

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