b. Glasgow Coma Scale. The Glasgow Coma Scale is an assessment based
on numeric scoring of a patient's responses based on the patient's best response to eye
opening, verbal response, and motor response. The patient's score (3 to 15) is
determined by adding his highest eye opening, verbal response, and motor response
Eye opening (1 to 4 points).
(a) Spontaneous: E4. Eyes are open and focused; the patient can
recognize you and follow eye movements.
(b) To voice: E3. The patient opens his eyes when spoken to or when
directed to do so.
To pain: E2. The patient opens his eyes when given some sort of
Verbal response (1 to 5 points).
(a) Oriented: V5. The patient can talk and answer questions about his
location, time, and who he is. In some situations, it is also appropriate to question the
patient to see if he is oriented to the event that led him to be in his current condition.
(b) Confused: V4. The patient can talk and speak coherently, but is
not entirely oriented to person, place, time, and event.
(c) Inappropriate words: V3. The patient answers with some sort of
inappropriate response to the question that was asked or answers with excessive use of
profanity that is not associated with anger toward the event.
Incomprehensible words: V2. Unintelligible words or sounds.
Motor response (1 to 6 points).
(a) Obeys command: M6. The patient can follow appropriate
commands or requests. It is also important to asses the patient for the ability to follow
commands across the central plane of the body. For example, the command, "Please
touch your left shoulder with your right arm," helps to ensure the patient can cross the
hemispheres of the brain since the left and right sides of the body are controlled by the
opposite sides of the brain.