How to learn the Glasgow scale

The Glasgow Scale is a practical measurement used to determine a person’s state of consciousness. To do this, different scores are assigned to the patient according to their response to certain tests.

Last update: 28 January, 2022

The Glasgow scale allows health professionals to know the level of consciousness of humans. To do this, it uses three parameters: the verbal response, the ocular response and the motor response.

This is a rapid neurological examination that is performed on patients who have suffered a head injury or when they are in a neurological state caused by a metabolic or vascular problem, such as cerebrovascular disease.

The goal of the Glasgow scale is not to determine the magnitude of the patient’s brain damage. The scale aims to measure the level of consciousness or alertness. It is a dynamic evaluation that must be carried out by a professional periodically to assess how the clinical situation changes.

How is the Glasgow scale?

The scale is composed of the exploration and quantification of three parameters: eye opening, verbal response and motor response. Each one is quantified in points according to the possible degrees or types of response to which a numerical value is assigned.

eye opening

  • The patient is assigned 4 points in case of spontaneous eye opening. This indicates that the patient is in a aware.
  • He is awarded 3 points if he opens his eyes only when called. In this case, the person is in a state somnolent.
  • The 2 points are assigned when the patient opens his eyes when a painful stimulus is applied, being in a state called stuporous.
  • Finally, 1 point is assigned when, despite all the previous stimuli, the patient remains with his eyes closed, which is sometimes compatible with the eat.

For example, a patient who has just had a seizure may be in a stuporous state for a few minutes.

verbal response

The neurological state is very changeable depending on the cause and the response to treatment. For this reason, the Glasgow scale should be used regularly, especially in emergencies.

To measure the verbal response on the Glasgow scale, the 5 points are assigned when the patient can respond adequately to an interrogation. In this situation, the person is in a state aware. 4 points are awarded when there is nonsense and incoherent language, i.e. somnolent.

When the person reacts with grumbles and obscenities, they are assigned 3 points, at which time they are also in a state of somnolent. For the assignment of the 2 points, it has to emit guttural and incomprehensible sounds (state of stupor). Lastly, he is given 1 point when he makes no sound (eat).

motor response

In the study of the motor response, the points are distributed as follows:

  • 6 points: when the patient obeys orders while in a state aware.
  • 5 points: if it responds with complex movements to a painful stimulus. When this situation occurs, the patient is in a state somnolent.
  • 4 points: when the patient attempts to withdraw from the applied painful stimulus.
  • 3 points: if the subject responds to a painful stimulus with a flexion movement. Thus, it is in a state of decortication.
  • 2 points: Instead of flexion movements, the patient must respond to the painful stimulus with extension movements. If this occurs, the person is in a state of decerebrate.
  • 1 point: if the patient does not react to any stimulus and is in eat.

How is it interpreted?

Once the exam is done, the points that have been assigned to each answer are counted. The minimum score that can be obtained is 3 and the maximum 15. Depending on the result obtained, the clinical severity can be classified.

In the context of head injuries, if the result is between 14-15 points, the situation is mild. If the score is between 9-13, the injury is moderate, and if it is below 9 points, the trauma is severe.

How do we learn the Glasgow scale?

The easiest and most used way to learn this scale is to use a mnemonic. There is a rule for each response we study.

Eye opening mnemonic

For eye opening the rule is “The eyes are frightened when they see pain”. To understand it, it is necessary to know what are the parameters that are studied in the eye opening, which are the ones explained above. The first word, “eyes”, has 4 letters. This indicates that to measure the eye opening we will have a maximum of 4 points.

Then there is the word “frightening”, which refers to the fact that the patient’s eyes are open without the need to apply any stimulus. “Seeing” helps us remember the verbal stimulus, that is, when we call him by his name and he opens his eyes. “Pain” is the word that we associate with the painful stimulus that is applied to the patient in the event that he does not respond to the verbal stimulus.

Verbal response mnemonic

There are many ways to memorize the Glasgow scale. You can take our example and modify it to your liking.

As for the verbal response, the following phrase is used: “a confused oriental said inappropriate words and incomprehensible sounds”. In this case, to remind us that in the verbal response the maximum that can be given is 5 points, we associate it with the word “speech” or “verb”, since they contain 5 letters.

“Oriented” refers to the state in which the patient is oriented. In this case, he could answer the interrogation. “Confused” when 4 points are associated with the patient because they speak incoherently and without meaning.

“Inappropriate words” helps us to remember the state in which the person responds with grumbles and obscenities. Finally, “incomprehensible sounds” refers to when the patient emits guttural or incomprehensible sounds.

Mnemonic rule of motor response

The last mnemonic is for the motor response that goes like this: “my motorboat smells like reflex”. To measure this response can be assigned, as we already know, 6 points.

The fact that the word “motor” tells us is that it has 6 letters. In this case, the “o” of odor, indicates the state in which the patient obeys orders. Thus, 6 points should be assigned. “it” of odor refers to the fact that the patient localizes painful stimuli and therefore would be given 5 points.

The syllable “re” of reflection it helps us to remember that the patient withdraws from the applied pain. The syllable “fle” to which he responds with a bending movement. Finally, the syllable “ex” is used to associate the movement of extension. This is done by the patient when faced with a painful stimulus. The syllable comes from the word reflection, and 2 points are assigned.

Nothing difficult, right? Although it is a tool used by doctors, it is also convenient for anyone to know its generalities in order to understand any clinical eventuality that may arise in their environment.

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