Tips to fill NMC OSCE Glasgow Coma Scale (GCS) correctly

Filling out the NMC OSCE Glasgow Coma Scale (GCS) correctly in examination is crucial for accurately assessing a patient’s level of consciousness. The NMC OSCE GCS chart is divided into three components: Eye Opening (E), Verbal Response (V), and Motor Response (M). Each component has a set of responses with corresponding scores.

Step-by-Step Guide to Filling Out the NMC OSCE GCS:

1. Eye Opening (E)

• E4: Spontaneous
  • The patient opens their eyes on their own without any external stimulus.
• E3: To Speech
  • The patient opens their eyes in response to a verbal command.
• E2: To Pain
  • The patient opens their eyes only in response to a painful stimulus (e.g., trapezius squeeze).
• E1: None
  • The patient does not open their eyes even in response to pain.
    
    

2. Verbal Response (V)

• V5: Oriented
  • The patient is fully oriented to time, place, and person. They can respond coherently.
• V4: Confused
  • The patient can speak but is confused or disoriented.
• V3: Inappropriate Words
  • The patient utters words, but they are inappropriate or unrelated to the situation.
• V2: Incomprehensible Sounds
  • The patient makes incomprehensible sounds, such as moaning or groaning.
• V1: None
  • The patient does not make any verbal response.

3. Motor Response (M)

• M6: Obeys Commands
  • The patient can follow simple commands, such as “squeeze my hand.”
• M5: Localizes Pain
  • The patient moves their hand or arm to the source of pain when stimulated.
• M4: Withdraws from Pain
  • The patient withdraws their limb when a painful stimulus is applied.
• M3: Flexion to Pain (Abnormal Flexion)
  • The patient shows abnormal flexion, such as decorticate posturing, in response to pain.
• M2: Extension to Pain (Abnormal Extension)
  • The patient exhibits abnormal extension, such as decerebrate posturing, in response to pain.
• M1: None
  • The patient does not show any motor response, even to painful stimuli.

Calculating the NMC OSCE GCS Score

• Total GCS Score = E (Eye) + V (Verbal) + M (Motor)
• The total score ranges from 3 (deep coma) to 15 (fully awake person).

Tips for NMC OSCE GCS Examination

1. Be Systematic:
   • Always assess and score each component (Eye, Verbal, Motor) one by one. Don’t skip or assume responses.
2. Ensure Accuracy:
   • If the patient is intubated or unable to speak or verbal response and document the total score appropriately.
3. Use Appropriate Stimuli:
   • For assessing pain response, use a painful stimulus such as a trapezius squeeze or supraorbital pressure. Avoid excessive force.
4. Document Clearly:
   • Write down each score (E, V, M) and the total GCS score. Ensure your documentation is clear and legible.
5. Communicate Findings:
   • If the GCS is less than 8, this indicates a severe brain injury, and the patient may require urgent medical intervention.

6. Familiarize Yourself:

• Practice calculating GCS scores with various patient scenarios to become confident in using the scale.

By following these steps, you can confidently and correctly fill out the Glasgow Coma Scale in the NMC OSCE examination, ensuring an accurate assessment of the patient’s neurological status.

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