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 Medical Abbreviation: A Closer Look At GCS - The Glasgow Coma Scale
Written By:
Paulette Campbell RN-BC, BSN, MJ
Certified Legal Nurse Consultant
Medical Abbreviation |
Meaning |
GCS |
The Glasgow Coma Scale |
The Glasgow Coma Scale, first introduced in 1974, provides healthcare professionals an objective way of assessing the conscious states of a person. Most often this scale is used to measure the level of consciousness after a head injury. There are three areas of function that a patient is assessed in; Eye Response, Verbal Response, and Motor Response.
The GCS is scored between three and fifteen. Three is the worst and fifteen is the best. Each response or lack of response is scored. A GCS score of 13 or higher indicates a mild brain injury, nine to twelve is indicative of moderate brain injury and eight or less indicates a severe brain injury. For pediatric patients who are 36 months or younger, there is a Pediatric GCS that should be utilized in order to assess their level of brain injury.
A moderate brain injury typically corresponds with an individual who has a loss of consciousness for thirty minutes or more. There are notable physical or cognitive impairments which may or may not resolve over time. Patients with GCS score in this area are likely to benefit from rehabilitation services.
A severe brain injury typically indicates someone who remains in a coma like unconscious state. These patients often do not have any meaningful responses nor do they demonstrate voluntary activities. Vegetative brain injury patients have lost the ability to demonstrate any interaction with their environment. They are even unable to demonstrate a pain response.
The GCS does have some limitations particularly for those injury victims with special conditions that limit their ability to respond. Another limitation is for those patients who are on ventilators – their verbal score is inhibited due to the intubation tube preventing communication. Other inhibitors to GCS assessment are; low oxygen levels, drug overdose, intoxication, and other metabolic disturbances that can interfere with a patient’s ability to respond appropriately. Further, spinal cord injury patients often can not be accurately assessed because the injury affects all of their motor score.
When reviewing GCS scores, it is important to see them not just in their aggregate score but listed with the separate components (Eye, Verbal, and Motor) and then all totaled for the summation. For example, it would be limiting to see a GCS simply assigned as an 11. Preferred documentation would have it listed as E3V3M5=GCS11. This allows practitioners to make better clinical decisions and judgments.
If you have a case that involves a brain injury with GCS scores and in need of medical chart review, do not hesitate to contact our offices at Medical Jurisprudence, Inc. We have many medical legal consulting solutions that have been designed to meet your practice needs. You can reach our office today at 630-551-0978 or by email at paulette@medicaljurisprudence.com.
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