The GCS is the summation of scores for eye, verbal, and motor responses. The minimum score is a 3 which
indicates deep coma or a brain-dead state
. The maximum is 15 which indicates a fully awake patient (the original maximum was 14, but the score has since been modified).
Is GCS 3 dead?
Although the presence of fixed, dilated pupils in association with a GCS score of 3 has led to a
100% mortality rate
in a number of studies,
9 , 13
our findings show that survival and even good outcome (although very rare) are still possible.
Can you recover from GCS 3?
Conclusions. 14.5% of patients with TBI and a GCS of 3 at presentation achieved a good outcome at
6 months
, and 6.9% of patients with GCS of 3 and bilateral fixed pupils on presentation to the ED achieved a good outcome at 6 months.
What does a GCS of 3 mean?
A GCS score of 3 is
the lowest possible score
and is associated with an extremely high mortality rate, with some researchers suggesting that there is no chance of survival.
What GCS score is concerning?
By convention, mild TBI is defined by a GCS score of
13 to 15
, moderate by 9 to 12, and severe by 8 or less. A patient with a GCS score of 13 to 15 but having an intracranial lesion may be classified as having a complicated mild TBI or even a moderate TBI.
Can you recover GCS 4?
4 The survival rate after a TBI, severe enough to cause deep coma and low Glasgow Coma Scale (GCS) scores, is generally poor, even in young adults. Studies show a very high overall mortality, ranging between 76% and 89%. 5, 6, 7 Of the surviving patients,
only very few recover to a good outcome
.
What does GCS 4 mean?
4 =
normal flexion
(withdraws to pain) 3 = abnormal flexion (decorticate response) 2 = extension (decerebrate response) 1 = none. NT = not testable.
How do I check my GCS score?
To calculate the patient’s GCS , you need to
add together the scores from eye opening, verbal response and motor response
. Added together, these give you an overall score out of the maximum of 15.
Is GCS 14 normal?
Classification of Severity of TBI
The relationship between the GCS Score and outcome l is the basis for a common classification of acute traumatic brain injury: Severe, GCS 3 to 8. Moderate, GCS 9 to 12. Mild,
GCS 13 to 15
.
What to do if GCS drops?
Contact the medical officer if there is any deterioration in the scores. Any drop in GCS
requires urgent medical review
. A MET call should be activated if there is a drop in the total GCS of 2 or more. The pupils are assessed as part of neurological observations.
What does GCS 9 mean?
Severe Head Injury—-GCS score of 8 or less
Moderate Head Injury
—-GCS score of 9 to 12 Mild Head Injury—-GCS score of 13 to 15 (Adapted from: Advanced Trauma Life Support: Course for Physicians, American College of Surgeons, 1993).
What is the highest GCS score?
In intubated patients, the maximum GCS score is
10T
and the minimum score is 2T. The GCS is often used to help define the severity of TBI. Mild head injuries are generally defined as those associated with a GCS score of 13-15, and moderate head injuries are those associated with a GCS score of 9-12.
At what GCS do you intubate?
In trauma, a Glasgow Coma Scale score (GCS)
of 8 or less
indicates a need for endotracheal intubation. Some advocate a similar approach for other causes of decreased consciousness, however, the loss of airway reflexes and risk of aspiration cannot be reliably predicted using the GCS alone.
Why is GCS important?
Assessment of level of consciousness using the Glasgow Coma Scale (GCS) is a tool requiring knowledge that is
important in detecting early deterioration in a patient’s level of consciousness
. Critical thinking used with the skill and knowledge in assessing the GCS is the foundation of all nursing practice.
How do you assess level of consciousness?
The tool we use to assess the level of consciousness is
the Glasgow Coma Scale (GCS)
. This tool is used at the bedside in conjunction with other clinical observations and it allows us to have a baseline and ongoing measurement of the level of consciousness (LOC) for our patients.
What is the lowest GCS score?
The lowest score for each category is 1, therefore the lowest score is
3
(no response to pain + no verbalisation + no eye opening). A GCS of 8 or less indicates severe injury, one of 9-12 moderate injury, and a GCS score of 13-15 is obtained when the injury is minor.
