Question 8#
A 25-year-old man is seen in the emergency department after he struck his head against the windshield in an automobile accident. He opens his eyes and withdraws his arm during painful stimulation ofhis hand. He responds verbally to questions with inappropriate words. His GCS score is:
A. 6B. 9
C. 12
D. 15
Correct Answer is B
Comment:
The initial assessment of the trauma patient includes the primary survey, resuscitation, secondary survey, and definitive care. Neurosurgical evaluation begins during the primary survey with the determination of the GCS score (usually referred to simply as the GCS) for the patient. The GCS is determined by adding the scores of the best responses of the patient in each of three categories. The motor score ranges from 1 to 6, verbal from 1 to 5, and eyes from 1 to 4. The GCS therefore ranges from 3 to 15, as detailed in Table below. Tracheal intubation or severe facial or eye swelling can impede verbal and eye responses. In these circumstances, the patient is given the score of 1 with a modifier, such as verbal "1T" where T = tube.
The Glasgow Coma Scale score* table:
*Add the three scores to obtain the Glasgow Coma Scale (GCS) score, which can range from 3 to 15 . Add 'T' after the GCS if intubated and no verbal score is possible. For thesme patients, the GCS can range from 3T to 10T.