How to Measure GCS to Assess Awareness Levels

Glasgow Coma Scale or GCS is a scale used to determine a person's level of consciousness. In the past, GCS was only used to determine the level of awareness of people suffering from head injuries. However, currently GCS is also used to assess the level of awareness when providing medical emergency relief. A person's level of consciousness can be assessed from three aspects namely the eyes, voice (speaking ability), and body movements. Before discussing how to find out your level of awareness with GCS, let's first discuss some of the causes that make a person's consciousness decrease.

Causes of the Decreased Level of Someone's Consciousness

The brain is the main organ in charge of maintaining awareness. In order to work properly, the brain needs adequate oxygen and glucose intake. Drinks such as coffee, chocolate, tea, and energy drinks that contain caffeine, have a stimulant effect on the brain, which can make a person more awake. Conversely, alcohol and certain drugs, such as sedatives, painkillers, epilepsy drugs, or stroke drugs, can have a drowsy effect and reduce the level of awareness. Certain conditions such as dementia (senile dementia), severe head injury, shock, heart disease, liver disease, kidney failure, hypoglycemia, and stroke can also damage brain cells and thus affect one's consciousness. The worst level of awareness is when someone is in a coma.

How to Measure Awareness Levels

The highest level of consciousness or arguably fully awake, is on a scale of 15. While the lowest or said to be comma, is on a scale of 3. To find out the GCS scale, the medical team will check as follows:

Eye

GCS values ​​evaluated through eye examination:
- If the medical team asks to open their eyes and stimulate someone with pain but the person's eyes do not react and remain closed, the GCS points obtained are 1.
- If the eyes are opened due to excitatory pain alone, the GCS points obtained are 2.
- If someone's eyes open only by hearing a sound or can follow the command to open their eyes, the GCS point obtained is 3.
- If the eyes open spontaneously without commands or touch, then the points gained are 4.


Sound

GCS values ​​evaluated in the voice response check:
- If someone does not make the slightest sound, even though it has been called or stimulated pain, then that person gets 1 point. - If the sound comes out like a groan without words, the points gained are 2.
- Someone can communicate but not clear or just put out words but not clear sentences, GCS points obtained are 3.
- If someone can answer a question from the medical team but the patient is like confusion or a non-fluent conversation, then the points gained are 4.
- A person can answer all questions posed correctly and is fully aware of the orientation of the location, the interlocutor, place, and time, then the points obtained are 5.


Movement

GCS values ​​that are evaluated in motion response checks:
- There is no response to body movements despite being instructed or given pain stimulation, GCS points obtained are 1.
- A person can only clench his fingers and toes, or bend his feet and hands when given pain stimulation, the points obtained are 2.
- A person only bends his arms and rotates his shoulders when given pain stimulation, the GCS points obtained are 3.
- A person can move the body away from the source of pain when stimulated by pain, GCS points obtained are 4. For example, a person can move his hands when pinched.
- The body part that is hurt can move and the person being examined can show the location of pain, the GCS points obtained are 5. For example when the hand is given pain stimulation, the hand will lift.
- A person can make movements when instructed, GCS points gained are 6.

The GCS scale is obtained by summing each point obtained from the three aspects of the examination above. This scale is used as an initial step to evaluate the condition of someone who has passed out or has just been in an accident and then unconscious, before being given further assistance. Although it can be done to determine the level of awareness, GCS cannot be used to diagnose the cause of decreased consciousness or coma. As a first helper, you can report GCS numbers to the medical person who handles the next. This calculation is useful for doctors as a basis for determining treatment, also for assessing response to treatment given.