Glasgow Coma Scale

Question 1

What is ACVPU ?

Answer 1

A very simple way to gain a rapid assessment of conscious level.

Question 2

ACVPU

Answer 2

Alert - 15
Level of confusion - 14 (10-14)
Responding to voice - 13 (12-14)
Responding to pain - 8 (7-9)
Unresponsive : 3-6

Question 3

Why should the Glasgow coma scale be used rather than ACVPU when handing over the care of a person ?

Answer 3

ACVPU gives no objective method of recording and comparing responses over time or handing over to other medical personnel.

Question 4

What are the 3 different components of the Glasgow coma scale ?

Answer 4

Eye opening
Verbal
Motor

Question 5

What is the max number of points for eye opening ?

Answer 5

4

Question 6

What is the max number of points for verbal response ?

Answer 6

5

Question 7

What is the max number of points for motor response ?

Answer 7

6

Question 8

What does a point of 1 mean on the GCS ?

Answer 8

NO response

Question 9

E1

Answer 9

Not opening eyes

Question 10

E2

Answer 10

Open to pressure

Question 11

E3

Answer 11

Open to sound

Question 12

E4

Answer 12

Open spontaneously

Question 13

V1

Answer 13

No verbal response

Question 14

V2

Answer 14

Incomprehensible sounds - moaning/ groaning

Question 15

V3

Answer 15

Inappropriate words

Question 16

V4

Answer 16

Confused speech / disoriented

Question 17

V5

Answer 17

Normal speech / oriented

Question 18

M1

Answer 18

No motor response

Question 19

M2

Answer 19

Extending to pain

Question 20

M3

Answer 20

Abnormal flexion to pain (difficult to asses, so often not used)

Question 21

M4

Answer 21

Normal flexion to pain - withdrawal

Question 22

M5

Answer 22

Localising to pain

Question 23

M6

Answer 23

Obeying commands

Question 24

Name the 3 methods for eyes and verbal response

Answer 24

Passive observation
Active observation
Active pressure stimulus

Question 25

Passive observation

Answer 25

Stand and watch the person for a short time If eyes are open : E4 as there is no stimulus

Question 26

Active observation

Answer 26

Talking to the person (you may need to illicit a response)

Question 27

Active pressure stimulus

Answer 27

Last step of assessment and is only necessary if the person has not responded to your voice. Apply pressure to the finger over the nail tip.

Question 28

What is the max GCS score ?

Answer 28

15

Question 29

What is the min GCS score ?

Answer 29

3

Question 30

GCS 14-15 : relating to head injury

Answer 30

Mild brain injury

Question 31

GCS 9-13 : relating to head injury

Answer 31

Moderate brain injury

Question 32

GCS 3-8 : relating to head injury

Answer 32

Severe brain injury Said to be in a coma if GCS score <8

Question 33

What actions should be taken for a person with a GCS score of < 8 ?

Answer 33

Steps must be taken to protect and secure the airway

Question 34

What should you do to apply pressure ?

Answer 34

Trapezius pinch Squeeze nail bed supraorbital notch