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The Glasgow coma scale is based on three aspects of a patient's behaviour - eye opening, verbal response and motor response ( see Table 1). A deterioration of one point in the ‘Motor Response' or one point in the ‘Verbal Response' or an overall deterioration of two points in the GCS is of clinical significance and must be reported to medical staff. recovery, ICU), a GCS must be assessed by both the nurse escorting the patient and the nurse receiving the patient (at the same time) in order to avoid misinterpretation and facilitate continuity of assessment.Ģ.9 Although the Glasgow coma scale should be communicated using its individual components, a score from 3 to 15 may be used to summarise the scale. Changes in a patient's neurologic function, pupil responses, or the GCS must be recorded in relevant nursing documentation including the date, time, and signature.Ģ.4 As the GCS is an assessment of conscious level, it cannot be determined with accuracy in the patient who is receiving anaesthetic agents neurological assessment then focuses on pupillary responses.Ģ.5 Some drugs may affect pupillary reaction and the effects of any prescribed medication must be considered when assessing the pupils.Ģ.6 A GCS can still be determined in a patient who is sedated although it must be noted that the score obtained might not be an accurate reflection of what the patient is capable of.Ģ.7 Within the neurosurgical intensive care and high dependency units, a GCS must be assessed at verbal handover/beginning of the shift by both nurses (at the same time) in order to avoid misinterpretation and facilitate continuity.Ģ.8 When a patient with an impaired level of consciousness is transferred to another ward/department (e.g. If the motor response is different on each side, the better response is incorporate within the Glasgow coma scale.Ģ.3 Responses must be recorded on the relevant observation chart in black ink. Spinal reflexes may cause the arms/legs to flex briskly in response to pain and must not be interpreted as a response.Ģ.2 Always record the best arm response. The following are important points to note when assessing a patient's level of consciousness using the Glasgow coma scale and calculating a Glasgow coma score (GCS).Ģ.1 The arms give a wider range of responses and for this reason are always observed using the Glasgow coma scale. Recommendations for assessing eye opening, verbal response and motor response are specified. The guidelines focus on the practical aspects of carrying out and interpreting the Glasgow coma scale and pupil responses. It is the method favoured by The Leeds Teaching Hospitals NHS Trust and these guidelines have been developed to standardise practice so that the Glasgow coma scale and pupil responses can be assessed in a consistent manner to minimise misinterpretation. The Glasgow coma scale developed by Teasdale and Jennett (1974) is the most widely used assessment tool to measure a patient's level of consciousness.

Introduction and BackgroundĪssessment of conscious level is an essential component of neurological examination and is usually performed together with assessment of pupillary size and reaction, vital signs, and focal neurological signs in the limbs. If you notice any results that fall outside these standards, be sure to schedule an eye exam with your Vision Source doctor.Guidelines for Assessing the Glasgow Coma Scale and Pupil Responses in Adultsĥ. Older children and adults should be able to read the majority of letters on the 20/20 line. A 3- to 4-year-old should be able to read the 20/40 line, and a 5-year-old the 20/30 line.

That depends on the age of the person being tested.

Cover the other eye and repeat steps 5-7.

Write down the number of the smallest line where you identified the majority of letters correctly (Ex. If you were able to read 5 out of 8 letters on line 8, you would write 20/20.).

Continue to the bottom row or until you can no longer read the letters.

Have another person point to each line as you read the letters out loud and keep track of which letters you get right.

Cover one eye (if you wear glasses for distance vision, keep them on).

Tack or tape the chart to a windowless wall in a well-lit room at eye level.

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Print the free eye chart on regular 8 1/2 x 11-inch paper.

PICTURE OF PUPIL SIZE CHART PROFESSIONAL

But it could help you identify potential vision problems that demand professional attention. Remember: This is not a substitute for a complete medical eye exam by a licensed optometrist. You can use this eye chart to check your entire family's vision.

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Simply click on the image to the right, and your download will begin. Searching for a free eye chart to check your vision at home?

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