Disability part 1

When assessing a patients’ level of consciousness, there are a number of assessments which can help identify and score their conscious level. A common assessment used is the Glasgow Coma Scale (GCS). The GCS assesses eye movement, verbal, and mechanical responses by the patient to give a score indicating what level of consciousness they are. The maximum score is 15, meaning the patient is fully conscious, whereas the lowest score is 3, meaning they are completely unconscious and unresponsive.   

The scoring is as follows; 

Eyes opening: 

Spontaneously – 4 

To Speech – 3 

To Pain – 2 

No response – 1 

Verbal response: 

Orientated – 5 

Confused – 4 

Inappropriate words – 3 

Incomprehensible sounds – 2 

No response – 1 

Motor response: 

Obeys commands – 6 

Localised pain – 5 

Withdraws from pain – 4 

Abnormal flexion – 3 

Extensor response – 2 

No response – 1 

Add up the different responses from each of the sections (Eye, Verbal, Movement response) to attain the score out of 15. For example; Eyes (E) open spontaneously – 4, Verbal (V) response confused – 4, Motor (M) response obeying commands – 6. GCS 14/15 (E4, V4, M6).   

Another form of assessment which is simpler than GCS is the AVPUscale: 

A – Alert 

V – Responds to Verbal 

P – Responds to Pain 

U – Unconscious 

AVPU can help give very quick information of a patients’ consciousness level to other clinicians without having to work out a score. For example, explaining the patient is current V on AVPU.