The Glasgow Coma Scale – doing it right

The Glasgow Coma Scale (GCS) was first developed by Teasdale and Jennett in 1970 to assess the level of consciousness in patients with head injury. Since then it has been used worldwide in assessment and decision-making in patients with acute neurological conditions at risk of clinical deterioration. As a staff nurse and now as a clinical nurse specialist in stroke, the GCS assessment has always been a part of my work life and I have lost count of how many times I have done it! But one thing is true: it has helped me and continues to help me (together with other assessments) in my nursing practice to recognise clinical deterioration in patients with an acute stroke.

Throughout the years I have also come across clinical situations where there was a discrepancy between nurses assessment or even between nurses and doctors.  In fact, there are still times not too far away where I have challenged doctors because both our assessment was different or where nurses have asked me for advice in their assessment. On the other side, peripherally and centrally applied painful stimuli have always been the subject of discussion amongst healthcare professionals.

Doing the GCS every day has undoubtedly built my confidence but for those working in areas where the GCS is not required regularly, this can be an issue. But if questions are still arising, it means that we must do better to ensure that all of us are doing it right.

Earlier this year, during the RCN Congress, Dr Sue Woodward and I gave a talk about the GCS. With the aim to continue helping nurses “doing it right”, we are holding a tweet chat on Wenurses on October 6th at 8pm (GMT Standard Time). I hope you join Dr Sue Woodward and I on the discussion. You can find more details about it at:

© Ismalia de Sousa, 2016