GLASGOW COMA SCALE : Do it this way

1 Open before stimulusAfter spoken or shouted requestAfter finger tip stimulusClosed by local factorAbnormal FlexionSlow SterotypedArm across chestForearm rotatesThumb clenchedLeg extendsNormal flexionRapidArm away from bodySTIMULA T ECHE C KOBSER V EFor further information and video demonstration visit COMA SCALE : Do it this wayR AT EFor factors Interfering with communication, ability to respond and other injuriesEye opening , content of speech and movements of right and left sidesSound: spoken or shoutedrequest Physical: Pressure on nger tip, trapezius or supraorbital notchAssign according to highest response observedCriterionObservedRatingScoreEye openingCriterionObservedRatingScoreVerba l responseCriterionObservedRatingScoreBest motor responseSites For Physical StimulationFinger tip pressureTrapezius PinchSupraorbital notchFeatures of Flexion ResponsesModi ed with permission from Van Der Naalt 2004 Ned Tijdschr GeneeskdVariableNo opening at any time, no interfering factorSpontaneousTo soundTo pressureNoneNon testable4321NT4321NT54321NT5 Correctly gives name, place and dateNot orientated.

2 But communication coherentIntelligible single wordsOnly moans / groansNo audible response, no interfering factorFactor interfering with communicationOrientatedConfusedWordsSoun dsNoneNon testableObey 2-part requestBrings hand above clavicle to stimulus on head/neckBends arm at elbow rapidly but features not predominantly abnormalBends arm at elbow, features clearly predominantly abnormalExtends arm at elbowNo movement in arms / legs, no interfering factorParalysed or other limiting factorObeys commandsLocalisingNormal exionAbnormal exionExtensionNoneNon testable6 Institute of Neurological Sciences NHS Greater GLASGOW and ClydeGraphic design by Margaret Frej based on layout and illustrations from Medical Illustration M I 268093