Post-trauma neurological assessment is essential to determine the victim's condition and to define the appropriate medical treatment. The Glasgow Coma Scale is a valuable tool for measuring central neurological function and classifying the severity of head injuries into three categories: mild, moderate and severe.
When the Glasgow Coma Scale is used, scores are assigned based on the victim's response to specific stimuli. These scores provide important information about brain function and allow monitoring of the victim's condition. In addition, this scale is reproducible, meaning that different examiners can obtain the same results when assessing the same situation.
In addition to grading the severity of the trauma, the Glasgow Coma Scale also helps determine whether the victim is able to adequately protect their airway. This information is essential to ensure the victim's safety and prevent potential respiratory complications.
In conclusion, the Glasgow Coma Scale is a crucial test in the evaluation of the neurological status of head injury victims. It provides valuable information on brain function and allows monitoring of the victim's condition over time. Its reproducibility makes it a reliable tool for health professionals who use this scale in their daily practice.
Definition and Meaning
The Glasgow Coma Scale is a test used to assess the neurological status of a person after a head injury. It measures central neurological function and classifies the severity of trauma into three categories: mild, moderate and severe. The scores obtained during this examination provide important information about brain function and allow the evolution of the victim's condition to be monitored over time.
Using the Glasgow Coma Scale
The Glasgow Coma Scale is particularly appropriate for trauma cases. It is especially important to document when the victim has suffered a head injury. It can also be used in the medical setting, such as when a person has an altered state of consciousness (AVPU).
Best Response
The literature refers to the term "best response" in relation to the Glasgow Scale. The rescuer should select the best response(s) obtained during the assessment of this test. The Glasgow Coma Scale is used to measure central neurological function, i.e., brain function.
Assessment of motor response
The "best response" is most often used when assessing motor response. The rescuer should not take into account the fact that the victim cannot move his or her legs due to a spinal cord injury or one arm due to a fracture or stroke. If there is a discrepancy in the response between the right and left sides, or between the arms and legs, then the best response should be recorded. It is important to note that the assessment of motor function in the calculation of the Glasgow Coma Scale validates central brain function and not peripheral neurological function.
Classification of severity of head injury
The Glasgow Coma Scale is used to create a classification of the severity of traumatic brain injury (TBI). Victims can be categorized into three broad categories:
- Mild TBI (score between 13-15),
- Moderate TBI (score between 9-12),
- Severe CBT (score between 3-8).
It is important to note that victims with a Glasgow Coma Scale score of 8 or less will not be able to adequately protect their airways and will therefore be at high risk for aspiration (secretions in the lower airways that can lead to infection).
ADULT GLASGOW COMA SCALE
- Eye Opening (Y):
- 4 pts - Spontaneous
- 3 pts - On command
- 2 pts - On pain
- 1 pt - Absent
- Verbal response (V)
- 5 pts - Oriented
- 4 pts - Confused conversation
- 3 pts - Inappropriate words
- 2 pts - Unintelligible sounds
- 1 pt - Absent
- Best Motor Response (M)
- 6 pts - Obeyed
- 5 pts - Localizes
- 4 pts - Withdrawal movements, to pain
- 3 pts - Abnormal flexion, to pain
- 2 pts - Extension movements, to pain
- 1 pt - Absent
Coma score = Y+M+V Minimum: 3 Maximum: 15
PEDIATRIC GLASGOW COMA SCALE
The calculation of the Glasgow score obviously needs to be adapted for children according to their age group (from 3 months to 16 years).
- Eye opening (Y)
- 4 pts - Spontaneous
- 3 pts - To noise / To voice
- 2 pts - To pain
- 1 pt - None
- Verbal response (V)
- 5 pts - Smiles, chirps or cries / Use of words or phrases
- 4 pts - Crying / Poor word usage
- 3 pts - Cries or shouts abnormally / Cry or shout
- 2 pts - Grunts
- 1 - None
- 5 years and older, use adult scale
- Motor Response (M)
- 6 pts - Normal spontaneous movements / Obeys commands
- 5 pts - Localizes pain
- 4 pts - Withdrawal to pain
- 3 pts - Flexion to pain
- 2 pts - Extension to pain
- 1 pt - None
TOTAL /15 points