Glasgow Coma Scale Mnemonic For Easy Recall?
Earlier yesterday, during my Surgery 1 posting at the Neurosurgery unit, our Senior Registrar, Dr. Opara, introduced us to the Glasgow Coma Scale shortly known as the GCS.
After the day’s work, I went back to read and understand it better. So today I am going to give you Glasgow coma scale mnemonic to remember this important aspect of your Neurology or Neurosurgery posting or practice.
First of all, I’d start with an explanation of all what the GCS means in the medical world. You’d then learn its importance and finally an easy mnemonic you can use to recall them even at the speed of light!
Are you ready to proceed on this learning adventure? Then let’s get to it immediately!
What is the Glasgow Coma Scale
When it comes to Neurology, there are different diseases and Injuries that present with several symptoms. And when you want to clerk the patient, there are very important things to check to gauge the level of consciousness, as well as the damage.
The need to correctly access this level of consciousness in patients prompted the development of the Glasgow Coma Scale. But what does this mean entirely?
The Glasgow Coma Scale (GCS) is the generally accepted method of accessing the state of a patient’s consciousness and activity after brain damage or severe trauma.
It is principally employed by Physicians and Doctors to determine the effect of the brain injury to a patient. The test helps provide accurate information concerning the patient’s condition so as for experts to profer adequate solutions.
Doctors such as Neurologists, Neurosurgeons, Orthopaedic surgeons, and other experts use the GCS usually to clerk injured patients before providing treatment.
What Feature does the Glasgow Coma Scale measure?
There are three important aspects of a patient’s normal health that the GCS measures. They are:
- Eye opening
- Verbal response
- Motor response
Now let’s talk about them separately and their importance in the clinic before we head to the Glasgow coma scale mnemonic.
Depending on the kind of brain injury, a patient may be able to open the eyes or not. The first feature that the GCS measures are the Eye-opening of the patient.
This aspect is graded in a scale of 1-4.
- 4: Spontaneous
- 3: response to verbal command
- 3: response to pain
- 1: No response
Now let’s get into details:
A normal healthy human will have his eyes opening spontaneously except when asleep or dozing. So when you come to the patient’s bed and notice that the patient’s eye is awake and normal, you grade him/her 4 in the eye-opening aspect of the Glasgow coma scale.
However, when the patient doesn’t open eyes spontaneously and you need to call his/her name or use the verbal commands, then you grade 3.
If none of the above opens the eye, and you have to inflict some mild pain or pressure physically for the eyes to open, then you grade 2.
And lastly, when nothing opens the eyes no matter which method you try, then you grade patient 1 in the eye-opening aspect of the GCS.
If you ask a normal healthy person a question, he/she will reason normally and give you an answer based on their understanding.
However, in patients with brain injury, this is not always true. They may present with different speech alterations. And you use the Verbal response from the GCS to perfectly access this patient.
The verbal response is graded in a scale of 1-5 as follows:
- 5: Oriented in time, place and person
- 4: Confused
- 3: Inappropriate
- 2: Incomprehensible
- 1: No verbal response
Now let’s get into details for this Glasgow Coma Scale:
When you ask the patient a question, let’s say “what is your name and why are you here?” and they respond perfectly, you should know the patient is normal in verbal response and grade him/her 5.
However, when you ask, and the patient doesn’t know the answer in regards to time, place, and person, then you grade 4. For example, you ask “why did you come to the hospital?” and he/she replies “Which hospital? I am not in the hospital. I am at home. Who are you?” You should already point out that the patient is confused.
Then, when the patient’s response to your question doesn’t fit with the question you ask, then grade 3. For example, you ask “how did you get this injury?” and the patient replies with “ the federal government commissioned a school yesterday”. From here, you could see that there is no correlation between what you asked the patient and the reply.
Fourthly, when the patient makes sounds or sentences that are incomprehensible, you should grade 2. Incomprehensible in this regard means sounds that you can’t understand.
Lastly, when the patient makes no sound, grade 1.
Most times, a brain injury damages the nerve connections in the body and causes loss of function or movement of some body parts. To perfectly access the patient in this regard, the Glasgow coma scale and its mnemonic will be super helpful!
There are 6 scales in this motor response:
- 6: Obeys command
- 5: Localized pain causes movement
- 4: Normal flexion
- 3: abnormal flexion
- 2: Extension
- 1: No motor response
Let me explain:
You grade 6 when your patient moves spontaneously without difficulties. 5 when he/she only moves by withdrawing body after you inflict a localized pain in one area.
Grade 4 is when you inflict a mild pain in one area and the patient withdraws to the pain. It’s also known as normal flexion.
However, when the patient flexes away from the pain, it is abnormal flexion and you should grade 3.
You also grade 2 when there is extension and 1 when a patient makes no movement.
Glasgow Coma Scale Mnemonic
Now let’s go to a mnemonic for easy recall that you can use to remember the GCS!
Eye-opening: To easily recall, the eye-opening aspect for the GCS, use the mnemonic Saturated Vapour Pressure (SVP). Where S means spontaneous, V means verbal command, and P means pain.
Verbal response: to easily remember what to ask during the verbal response, use the mnemonic OCI^2. Where O means Oriented, C means confused, the first I means inappropriate and the second means Incomprehensible. As you know the last means no response.
Motor response: to easily remember the GCS scale for a motor response, use “Obi Loves Nutmeg And Eggs”. Where O in Obi means Obeys command, L in loves means Localized pain, N in Nutmeg means Normal flexion, A in and means Abnormal flexion, E means Extension and as usual the last is no response.
Also Read: Lumbar plexus mnemonic for easy recall
Final words on the Glasgow Coma Scale Mnemonic
Here’s a summary of the mnemonic you can use to remember the Glasgow coma scale. For eye-opening- SVP, vocal response- OCI^2, motor response- Obi Loves Nutmeg and Eggs.
So there you go! You have now learned all about the Glasgow Coma Scale as well as what each of them stands for, and an easy mnemonic to remember them with! Have you got any questions? Let’s interact using the comment section below!