Live Syllabus

CODE:

A. Eye Opening Response:
4 Spontaneous
3 To Voice
2 To Pain
1 None
7 Patient chemically paralyzed or in chemically-induced coma for treatment purposes;*sedated
9 Unknown eye opening response

B. Best Verbal Response:
5 Oriented
4 Confused
3 Inappropriate Speech
2 Incomprehensible Sounds
1 None
7 Patient chemically paralyzed or in chemically-induced coma for treatment purposes;*sedated
8 Patient intubated at time of scoring
9 Unknown verbal response

C. Best Motor Response:
6 Obeys Commands
5 Localizes Pain
4 Withdraws from Pain
3 Flexion to Pain
2 Extension to Pain
1 None
7 Patient chemically paralyzed or in chemically-induced coma for treatment purposes;*sedated
9 Unknown motor response

D. Total GCS Score - add eye opening response, verbal response, and motor response. Add preceding zero to Total if single-digit.
77 Patient chemically paralyzed or in chemically-induced coma for treatment purposes;*sedated
88 Patient intubated at time of scoring
99 Unknown Total GCS score

NOTE:

If only 1 GCS is recorded, use that score for an assessment.

If patient is in barbiturate coma or paralyzed by use of Pavalin at the time of assessment, record individual items as 7 and total as 77. The coma or paralysis must be induced by medical personnel and not by patient. *Other medications indicating sedation include midazolam (VERSED), lorzaepam (ATIVAN), vecuronium (NORCURON), and pentobarbital (NEMBUTAL).

Only code "chemically induced coma" with neuromuscular blocking agents or barbiturates.

If patient is intubated at the time of assessment, record the verbal score as 8 and the total score as 88. For the purposes of analysis, these cases will not be included unless specified for recoding during analysis.

If patient is intubated and in chemically-induced coma or paralysis, code 8 for verbal response and 7's for eye opening, motor response and total GCS.

SOURCE:

Teasdale G, Jennett B (1976) Assessment and Prognosis of Coma After Head Injury, Acta Neurochir 34, 45-55. *For an abstract of this article, see: PubMed:Teasdale et al (1976) (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=961490).

EXAMPLE:

On admission to the Model System emergency department, patient was intubated. The patient had no eye opening or motor responses and made incomprehensible noises.

Eye Opening 1
Verbal Response 8
Motor Response 1
Total 88