The Glasgow Scale, also known as the Glasgow Coma Scale, is a technique that was developed at the University of Glasgow, Scotland, to assess trauma situations, namely traumatic brain injury, allowing the identification of neurological problems, the assessment of the level the person's awareness and predict the prognosis.
The Glasgow Scale allows you to determine a person's level of consciousness by observing their behavior. The evaluation is done through its reactivity towards certain stimuli, in which 3 parameters are observed: eye opening, motor reaction and verbal response.
How is determined
The Glasgow Scale determination should be performed in cases where there is suspicion of traumatic brain injury and should be done about 6 hours after the trauma, since during the first hours, in most cases, people are sedated to be intubated or to feel less pain, which can interfere with the assessment of the level of consciousness. Find out what a traumatic brain injury is, what the symptoms are and how the treatment is done.
The determination must be made by health professionals with adequate training, through the person's reactivity to certain stimuli, taking into account 3 parameters:
| Variables | Score | |
|---|---|---|
| Eye opening | Spontaneous | 4 |
| When stimulated by the voice | 3 | |
| When stimulated by pain | 2 | |
| Absent | 1 | |
| Not applicable (edema or hematoma that allows eyes to open) | - | |
| Verbal response | Oriented | 5 |
| Confused | 4 | |
| Only words | 3 | |
| Only sounds / moans | 2 | |
| No reply | 1 | |
| Not applicable (intubated patients) | - | |
| Motor response | Obey orders | 6 |
| Localizes pain / stimulus | 5 | |
| Normal flexion | 4 | |
| Abnormal flexion | 3 | |
| Abnormal extension | 2 | |
| No response | 1 |
The traumatic brain injury can be classified as mild, moderate or severe, according to the score obtained by the Glasgow Scale.
In each of the 3 parameters, a score is assigned between 3 and 15. Scores close to 15, represent a normal level of consciousness and scores below 8 are considered to be cases of coma, which are the most severe cases and with the most urgent treatment.. A score of 3 can mean brain death, however, it is necessary to evaluate other parameters to confirm it.
Possible method failures
Despite being a widely used method, the Glasgow Scale has some flaws, such as the inability to assess verbal response in people who are intubated or aphasic, and excludes the assessment of brainstem reflexes. In addition, if the person is sedated, assessing the level of consciousness can also be difficult.
