Examination Conscious Level Assessment

A wide variety of systemic and intracranial problems produce depression of conscious level. Accurate assessment and recording are essential to determine deterioration or improvement in a patient's condition. In 1974 Teasdale and Jennett, in Glasgow, developed a system for conscious level assessment. They discarded vague terms such as stupor, semicoma and deep coma, and described conscious level in terms of EYE opening,

VERBAL response and MOTOR response.

The Glasgow coma scale is now used widely in Britain and in many centres throughout the world. Recording is consistent irrespective of the status of the observer and can be carried out just as reliably by nurse as by neurosurgeon.

EYE OPENING - 4 categories

(i) Spontaneous

Supraorbital nerve or finger nail pressure

VERBAL RESPONSE - 5 categories

(i) Orientated - Knows place, e.g. Royal Free Hospital apd time, e.g. day, month and year

(ii) Confused - Talking in sentences but disorientated in time and place

(iii) Words - Utters occasional words rather than sentences

(iv) Sounds - Groans or grunts, but no words

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