Glasgow Coma Scale (GCS) einfach erklärt

Summary

This video explains the Glasgow Coma Scale (GCS), a clinical tool used to assess a person's level of consciousness based on eye opening, verbal response, and motor response. Developed in 1974, the GCS assigns points for each category, totaling a score between 3 and 15, which helps categorize brain injuries as mild, moderate, or severe. The video also covers how to apply the scale with real-life examples and includes a helpful mnemonic for quick memorization. It highlights the importance of the scale in trauma care and addresses limitations, including its inapplicability in certain cases, like intubation.

Takeaways

• 😀 The Glasgow Coma Scale (GCS) helps assess a person's level of consciousness quickly and uniformly, using three categories: eye opening, verbal response, and motor response.
• 😀 GCS was developed in 1974 by neurosurgeons Graham Teasdale and Bryan Jennett at the University of Glasgow, and is named after the Scottish city.
• 😀 Each of the three GCS categories (eye opening, verbal response, motor response) is evaluated on a scale and assigned a point value, which is then summed to give a score between 3 and 15.
• 😀 A GCS score of 13-15 indicates a mild traumatic brain injury (TBI), 9-12 represents a moderate TBI, and a score of 8 or lower signals a severe TBI.
• 😀 For assessing eye opening, points are assigned based on whether the eyes open spontaneously, to verbal stimuli, or only after a painful stimulus.
• 😀 Verbal response is evaluated on whether the person makes no sound, incomprehensible sounds, understandable words, disoriented speech, or is fully oriented and able to converse.
• 😀 The motor response category measures how the person reacts to pain, ranging from no movement to purposeful, targeted responses to pain.
• 😀 The GCS is useful in the clinical setting, allowing for rapid assessment of consciousness, which is particularly important for triaging patients with potential brain injuries.
• 😀 For patients who are intubated or otherwise unable to provide a verbal response, the GCS should be modified to note ‘NT’ (not testable) but not assign zero points.
• 😀 There is a pediatric version of the GCS, called the Pediatric Glasgow Coma Scale, designed for children, where the verbal response categories differ slightly.
• 😀 The acronym 'Eye, Talk, Bend' can serve as a mnemonic to remember the three GCS categories and their corresponding scores (Eye = 4, Talk = 5, Bend = 6).

Q & A

What is the purpose of the Glasgow Coma Scale (GCS)?

The purpose of the Glasgow Coma Scale (GCS) is to quickly and uniformly assess a person's level of consciousness in clinical settings, specifically in cases of head injuries, to determine the severity of a brain injury.

What are the three categories assessed by the GCS?

The three categories assessed by the GCS are eye opening, verbal response, and motor response.

How is the eye opening category scored in the GCS?

Eye opening is scored as follows: 1 point for no eye opening, 2 points if the eyes open in response to pain, 3 points if the eyes open in response to speech, and 4 points if the eyes open spontaneously.

What are the different possible scores for verbal response in the GCS?

The verbal response is scored as: 1 point for no verbal response, 2 points for incomprehensible sounds, 3 points for inappropriate words, 4 points for disoriented conversation, and 5 points for oriented conversation.

How is motor response evaluated in the GCS?

Motor response is scored as follows: 1 point for no motor response, 2 points for abnormal extension (decerebrate posturing), 3 points for abnormal flexion (decorticate posturing), 4 points for withdrawal from pain, 5 points for purposeful movement, and 6 points for following commands.

What is the range of possible GCS scores?

The total GCS score ranges from 3 to 15 points, with 3 being the worst possible score (deep coma or death) and 15 being the best possible score (fully conscious).

What does a GCS score between 13 and 15 indicate?

A GCS score between 13 and 15 indicates a mild head injury.

When should intubation be considered according to the GCS?

Intubation should be considered when the GCS score is 8 or lower, as it indicates a significant risk to the airway and breathing.

What is the significance of a GCS score of 8 or lower?

A GCS score of 8 or lower indicates a severe head injury, and it is crucial to consider airway management, such as intubation, to secure the patient's breathing.

Why should the GCS not be used in children without modification?

The GCS is primarily designed for adults, and for children, a modified version, known as the Pediatric Glasgow Coma Scale, should be used, as the scoring for verbal response differs for children.