It is a scale used to measure awareness and the evolution of brain damage in a patient. “The index is based on a scale of points ranging from 3 to 15 and evaluates eye opening, motor and verbal response”, says intensive care physician Douglas Ferrari, president of the Brazilian Society of Intensive Therapy. The assessment consists of a clinical examination. To get the answers, health professionals ask patients to open their eyes and provoke situations capable of generating motor, verbal or pain reactions. It’s even worth a pinch or a poke. If the person does not react or is slower, as in cases of accidents with drunk drivers, points are lost. The technique, created in 1974, is mainly used in pre-hospital care, to perform an initial assessment. “At the hospital, it is redone so that the team can compare the evolution of the condition. Thus, physicians have a parameter to assess whether the patient has improved, worsened or is in the same situation”, says Josiene Germano, specialist in traffic medicine, from Ribeirão Preto (SP). The scale is also important in cases of strokes, infections and intoxication with drugs such as barbiturates, cocaine and alcohol and in ICUs, to assess the improvement of comatose patients. Therefore, all doctors, nurses, physiotherapists and even firefighters who provide emergency care need to have the index on the tip of their tongue. The name comes from the University of Glasgow, in Scotland, where neurosurgeons Graham Teasdale and Bryan Jennett, creators of the scale, worked.
Verbal reaction, eyes and movement are worth points that indicate the patient’s degree of coma
open your eyes
… spontaneously – 4
… after verbal stimulation – 3
… after painful stimulus – 2
Does not open – 1
move around
… in an orderly manner, upon hearing a command – 5
Does not move, but locates source of pain – 4
… withdrawing the limb when feeling pain – 3
… folding arms over body when feeling pain – 2
… twisting the body and turning the wrists out when feeling pain – 1
does not move
Responds to verbal stimuli
… in a targeted way – 5
… in a confused way – 4
… without forming sentences, but articulates words – 3
… emitting incomprehensible sounds – 2
Does not answer – 1
FINAL RESULT
13 to 15 points: Mild injury
Person can open eyes, talk, and respond to pain and stimuli
10 to 12 points: Moderate injury
The patient does not have adequate eye opening and does not respond easily to stimuli
4 to 9 points: Severe injury
The patient is unconscious and having difficulty breathing. Therefore, he needs to be intubated.
3 points: Severe injury
The patient has no response. He is in a coma and may be brain dead.