You assess Maisie’s GCS and discover she is opening her eyes to pressure, that she is only making moan/groaning sounds and she’s withdrawing to pain (normal flexion) on the unaffected side.
Q. Please now score the GCS based on Maisie’s results:
Revisit our background information on the scale if you would like help with this task.
Verbal response: | 1 | 2 ✓ | 3 | 4 | 5 | |
Eyes open: | 1 | 2 ✓ | 3 | 4 | ||
Motor response: | 1 | 2 | 3 | 4 ✓ | 5 | 6 |
TOTAL: | 8/15 |
Maisie’s GCS score is 8 (verbal: 2, eyes opening: 2, and motor response: 4).
4am on the Stroke Unit
What would you do immediately?
Page last reviewed: 03 Mar 2021