The Glasgow Coma Scale (GCS) was originally described by Teasdale and Jennett (1974). A patient opens eyes to pain (E2), makes incomprehensible sounds (V2), and demonstrates abnormal flexion posturing (M3). What is the GCS score and what clinical state does it indicate?
- A GCS 7 — severe brain injury (GCS ≤8 indicates coma requiring airway protection) ✓
- B GCS 9 — moderate brain injury; no airway intervention needed
- C GCS 5 — vegetative state
- D GCS 11 — mild brain injury
Correct answer: A. GCS 7 — severe brain injury (GCS ≤8 indicates coma requiring airway protection)
Explanation
GCS calculation: Eyes E2 + Verbal V2 + Motor M3 = 7. GCS ≤8 defines coma (inability to open eyes, obey commands, or speak meaningfully) and is the threshold for consideration of endotracheal intubation to protect the airway, reduce aspiration risk, and allow controlled ventilation in head-injured patients. Severe brain injury is defined as GCS ≤8. Moderate injury is GCS 9–12; mild is GCS 13–15. Decerebrate posturing (abnormal extension, M2) indicates more severe injury than decorticate (abnormal flexion, M3) and typically suggests brainstem involvement.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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