Assessment of awareness level, GCS (Glasglow Coma Scale) Examination

Level of awareness assessment   is an assessment mechanism in the medical, that aims to measure a person's awareness and response to stimuli from the environment. toassess the magnitude and in the medical world known as the GCS examination. GCS Examination (Glasglow ComaScale) Must be understood by a health worker, whose function is to measure the level of awareness of the patient.


The GCS theory was first introduced in 1974 by Teasdale with Jennett. GCS uses to measure individual patients, comparing treatment effectiveness and factors determining prognosis.

Glasgow Coma Scale (GCS) is a scale used to determine / assess the level of awareness of patients, from fully conscious to a coma. The scoring technique with this scale consists of three assessments of the response shown by the patient after being given certain stimuli, namely open eye response, best motor response, and verbal response. Each assessment includes points, where the highest point total is 15.

While the understanding of Glasgow Coma Scale in the Internal Medicine Textbook, FKUI, 2006 is the scale used to measure the level of patient awareness, whether the patient is in a coma or not, by assessing the patient's response to the stimuli we give.

GCS assessment techniques consist of three assessments of the response shown by the patient after being given certain stimuli, namely open eye response, best motor response, and verbal response. Each assessment includes points, where the highest total point of 15 means normal patients.

Following is the Table of GCS Examination Scores (Glasglow Coma Scale)

Measurement
Response
Score
Eye (eye opening response)
Spontaneous Open eyes
4
Open your eyes with commands (voice, touch)
3
Open eyes with pain stimuli.
2
Do not open your eyes with any stimuli
1
Verbal (verbal / speaking response)
Good orientation
5
Confused, talk disruptive, disorientation of place and time)
4
Can form words but cannot form sentences
3
Can sound without meaning (groaning)
2
No voice
1
Motor (motoric response)
Follow the order
6
Localize pain (reach & keep stimulus away when given pain stimuli)
5
Withdraw (avoid / pull extremities or keep the body away from stimulus when given pain stimulation
4
Stay away from pain stimuli
3
Spontaneous extension
2
There is no movement
1

GCS Normal Value
15

To download the GCS Measurement table, HERE

Usually the GCS measurement results are written in the form of letter symbols, namely the value of E, the value of M and the value of V.   Then all the scores obtained from eye, verbal and motorized examinations are all summed up,   the highest GCS value or   GCS Normal   is 15   that is E4 V5 M6 and the lowest is 3 that is E1 V1 M1. Usually, patients with GCS values below 5 are emergency patients who are difficult to maintain their safety.

The level of awareness can be divided into several levels, namely:
Composmentist, which is the condition of a person who is fully aware of both himself and his environment and can answer the questions asked by the examiner well.
Apathy, namely the condition of someone who seems reluctant and indifferent to their environment.
Delirium, which is the condition of a person who experiences movement disorder, a wakeful sleep cycle that is disturbed and looks noisy, anxious, confused, disorientated and struggling.
Somnolen, that is, the condition of a person who is drowsy but can still be conscious if stimulated, but if the stimuli stop will fall asleep again.
Sopor, which is the condition of a person who is deep sleepy, but can still be awakened by a strong stimulus, for example pain stimulation, but not fully awake and unable to answer the question properly.
Semi-coma, namely a decrease in consciousness that does not respond to questions, cannot be awakened at all, the response to pain stimuli is minimal, but the corneal and pupillary reflexes are still good.
coma, which is a very deep decrease in consciousness, responding to questions, no movement, and no response to pain stimuli.
Following is the level of awareness based on the scale of the scores obtained from the GCS assessment of patients:
  • The Value of GCS Composmentis : (15-14)
  • The Values of GCS Apathetic          :   (13-12)
  • The Values of GCS Delirium          :   (11-10)
  • The Values of GCS Somnolen         :   (9-7)
  • The Values of GCS Sopor                :   (6-5)
  • The Values of GCS Semi Coma :   (4)
  • The Values of GCS Coma                 :   (3)
In addition, according to the basic life guidebook support with GCS we can also determine the degree of injury to the patient's head, which we can value from the sum of E, V and M values, after we examine the patient using GCS (Glasglow Coma Scale).
The degree of head injury based on the GCS value is as follows:
  • GCS: 13-14  = mild head injury
  • GCS: 9-12    = moderate head injury
  • GCS: 3-8      = severe head injury
Thank you for reading the article " Assessment of awareness level, GCS (Glasglow Coma Scale) Examination "Hopefully useful.

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