Gcs aka Glasgow Coma Scale, an assessment of a person's level of consciousness

A person's level of consciousness can be assessed from three indicators, namely the eyes, the ability to speak, and body movements. The Glasgow Coma Scale, aka GCS, is the most commonly used grading system to describe a person's level of consciousness after an acute head injury.

The test's method is simple but reliable and objective enough to record the initial and subsequent levels of consciousness in a person following a head injury. See a more complete explanation of the Glasgow Coma Scale test below.

The origin of the Glasgow Coma Scale

Glasgow Coma Scale is a method of assessing a person's level of consciousness. This method of assessment was developed in 1974 by British neurosurgeons Graham Teasdale and Bryan Jennet. The two experts shared a common interest in head injuries and the mechanisms of acute brain damage, a subject that neurologists previously had little interest in.

Graham Teasdale's interest in the subject of head injuries and clinical research began when he underwent basic medical and surgical training at the Royal Victoria Hospital, Newcastle. Around 1970, he had the opportunity to give material at the Institute of Neurological Sciences, Glasgow with Professor Bryan Jennett. The two then published a paper on the assessment of coma and impaired consciousness by proposing a structured research method known as the Glasgow Coma Scale.

After 40 years have passed, this method is still considered effective and objective in assessing the level of consciousness of a person after experiencing a head injury.

If in the past the Glasgow Coma Scale aka GCS was only used to determine a person's consciousness after experiencing a head injury, now this method is also used by doctors to assess the level of consciousness due to various other medical emergency conditions. Some of these conditions include:

• Ischemic stroke
• Intracranial infection
• Brain abscess
• Generalized physical injury
• Non-traumatic coma
• Poisoning

Keep in mind though that this scale can used to determine the level of consciousness a person, this assessment cannot be used to diagnose the cause of a person experiencing loss of consciousness or a coma.

Level of consciousness and brain activity

Your brain has a function to maintain awareness. To perform these functions optimally, your brain needs adequate oxygen and glucose intake. Yes, there are many substances in the food or drink you consume, which affect the chemicals in the brain. These substances can help maintain or even lower your awareness of, for example, caffeine.

Beverages such as coffee, soda, chocolate, tea, and energy drinks contain caffeine which can increase brain activity, thereby making you more awake. On the other hand, painkillers, sedatives, and alcohol make you sleepy, thereby lowering your consciousness.

Certain conditions that damage brain cells can also affect your consciousness, for example, severe head injury, dementia, Alzheimer's disease, Parkinson's disease, or stroke. Coma is the most severe loss of consciousness. Coma is caused due to swelling or bleeding in the brain tissue.

The swelling that occurs in the brain tissue makes the brain that is in the skull become crushed. As a result, brain pressure increases dramatically. Blood and oxygen are blocked from entering the brain. At this stage, brain function is disrupted. People who are in a coma are still alive, but they are unable to respond to any stimuli, including pain.

Guidelines for measuring the level of consciousness using the Glasgow Coma Scale (GCS)

To find out how good your level of consciousness is, your doctor or medical team will do a GCS assessment. Doctors use this assessment to assess eye response, speech, and body movements. The GCS score or value is obtained by adding up the values ​​obtained from the indicators below.

Eye response

• If the patient's eyes open spontaneously by blinking without the medical team providing stimulation, the GCS points are 4.
• If the patient's eyes are open when the medical team provides verbal stimulation, aka by voice or command, the GCS score is 3.
• If the patient's eyes are opened when the medical team provides pain stimulation, then the GCS points obtained are 2.
• If the patient's eyes do not open at all or remain tightly closed even though the medical team has given orders and pain stimulation, then the GCS points obtained are 1.

Sound

• If the patient is able to answer all the questions asked by the medical team correctly, the GCS points will be 5.
• If the patient shows confusion, but is able to answer questions clearly, then the GCS points obtained are 4.
• If the patient is able to communicate but only utters words instead of clear sentences, then the GCS points obtained are 3.
• If the patient only groans or makes a groaning sound without words, then the GCS points obtained are 2.
• If the patient does not make a sound at all, even though the medical team has invited him to communicate or stimulates his fingertips, the GCS points obtained are 1.

Movement

• If the patient is able to obey two different orders from the medical team, then the GCS points obtained are 6.
• If the patient is able to raise his hand when given pain stimulation in the area by the medical team, and he is also able to show which point is painful, then the GCS points will be 5.
• If the patient is able to avoid it when the medical team provides pain stimulation, but it is not directed to the pain point, the GCS points will be 4.
• If the patient only folds the elbow when he is given pain stimulation, then the GCS points obtained are 3.
• If the patient can only open the elbow when given pain stimulation by the medical team, the GCS points will be 2.
• If the patient does not respond to body movements at all even though the medical team has given stimulation or orders, then the GCS points obtained are 1.

A patient can be said to have a high level of consciousness if the score reaches 15. While someone is said to have a low level of consciousness, or is said to be in a coma if the score is only 3.