Verbal response (5)

This is the second parameter scale of the Glasgow Coma scale where we check the patient’s speech.

 ( 1 )None – No verbal response

( 2 )Sound  -Incomprehensible sounds such as Groans or grunts but no words.

( 3 )Words –  Inappropriate words such as asking something and replying to something else. 

( 4 )Confused  –  Talking in sentences but disoriented in time and place.

( 5) Oriented – Knows place, e.g. Southern General Hospital, and time, e.g.days, months, and years.

Motor response (6)

This is the third parameter scale of the Glasgow Coma scale where we check the motor movement of various limbs. The muscles contract which develops the motor activities.

( 1 )None -No motor response.

( 2 )Extending to pain – Abnormal extension to pain. If in response to the same stimulus elbow extension occurs, record it as’ extending to pain’. This is always accompanied by spastic flexion of wrist. 

( 3 )Flexing to pain – If the patient does not localize to supraorbital pressure, apply pressure with a pen or hard object to the nail bed. Record elbow flexion as ‘flexing to pain’. The Spastic wrist flexion may or may not accompany this response. 

( 4 )Withdrawal from pain – When the patient feels pain stimulus given by any health care professional. The patient tries to withdraw the hand of a healthcare professional. 

( 5)Localizing to pain – Apply a painful stimulus to the supraorbital area, e.g. thumbnail in supraorbital groove, increasing pressure until a response is obtained. If patient responds by bringing the hand up beyond the chin’ localizing to pain‘ ( Pressure to the nail bed or sternum at this stage may not differentiate ‘localizing’ from’ flexing’.)

( 6 )Obeys commands – The patient moves spontaneously and purposefully.