A veterinary nurse's guide to the Modified Glasgow Coma Scale

The Modified Glasgow Coma Scale (MGCS) has been adapted from the human Glasgow Coma Scale (GCS) which was created in 1974 as an objective way to assess the level of consciousness in humans following a traumatic brain injury and coma. The assessments are performed at initial presentation and repeated several times a day during hospitalisation to monitor the patient for progression of neurological signs (Trub, 2016) (Table 1). The GCS was modified for use in veterinary patients in 1983 by the Chief of Neurosurgery and Neurology as the Mississippi State University College of Veterinary Medicine. The scale was proposed as an objective way to evaluate the neurological status of dogs after traumatic brain injury, assess overall prognosis and evaluate neurological function alongside the neurological examination (Trub, 2016). Although the scale was developed specifically for head trauma patients, it can be used to monitor any patient with changes to level of consciousness, including patients that are quieter than usual to those which are comatose. In these patients, the scale is useful to indicate severity and any improvement or decline of neurological function and can act as a prognostic indicator to advise and inform clinical decisions and communicate prognostic information to owners (Trub, 2016). The three areas the MGCS evaluates are level of consciousness, motor activity and brain stem reflexes and each is given a score between 1 and 6. The evaluation and reasons behind the evaluation are discussed below.