GCS
The Glasgow Coma Scale (GCS) was developed in 1974 to describe the level of consciousness specifically in patients with head injury although it is now used widely as a shorthand for all manner of presentations and has generally been validated, although concerns remain about its use in certain scenarios .
It measures the best eye, verbal, and motor responses. Each is graded from worst (=1) to best (4, 5 and 6 respectively) and the grades added together, such that the lowest possible score is 3 and the highest is 15.
Best eye response (E)
Graded 1-4:
- patient responds to pressure on the patient’s fingernail bed
- if this does not elicit a response (or hands are unavailable) supraorbital and sternal pressure or rub may be used
- not to be confused with the awakening of a sleeping person (such patients receive a score of 4, not 3)
Best verbal response (V)
Graded 1-5:
- groaning or moaning but no words
- random or exclamatory articulated speech, but no conversational exchange
- responds to questions coherently but there is some disorientation
- responds coherently and appropriately to questions such as the patient’s name and age, where they are and why, the year, month, etc.
Best motor response (M)
Graded 1-6
- extensor posturing: abduction of arm, external rotation of shoulder, supination of forearm, extension of wrist, decerebrate response
- flexor posturing: adduction of arm, internal rotation of shoulder, pronation of forearm, flexion of wrist, decorticate response
- flexion of elbow, supination of forearm, flexion of wrist when supraorbital pressure applied; pulls part of body away when nail bed pinched
- purposeful movements towards painful stimuli
Siehe auch:
Assoziationen und Differentialdiagnosen zu Glasgow Coma Scale: