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BC Emergency Health Services

Body guides

Simple pictures for the things you'll check on every patient.

Glasgow Coma Scale (GCS)

Eyes (E) — 4

  • 4Opens on their own
  • 3Opens to voice
  • 2Opens to pain
  • 1No eye opening

Verbal (V) — 5

  • 5Oriented
  • 4Confused
  • 3Inappropriate words
  • 2Sounds only
  • 1No sounds

Motor (M) — 6

  • 6Obeys commands
  • 5Localizes pain
  • 4Withdraws from pain
  • 3Abnormal flexion
  • 2Extension
  • 1No movement

Add the three scores. 15 is fully alert, 3 is the lowest possible.

PERRL — checking pupils

  1. PPupils
  2. EEqual — same size on both sides
  3. RRound — normal circle shape
  4. RReactive — get smaller to
  5. LLight — shine a penlight in from the side

Unequal or non-reactive pupils can mean a head injury, stroke or drugs. Report it.

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Listening to the lungs

  1. 1Right upper — just below the collarbone
  2. 2Left upper — just below the collarbone
  3. 3Right lower — side of the chest, mid-armpit line
  4. 4Left lower — side of the chest, mid-armpit line

Compare left and right at the same level. Listen to a full breath at each spot.

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Patient assessment model

  1. 1Scene assessment — hazards, PPE, number of patients, mechanism
  2. 2Primary survey — LOC, airway, breathing, circulation, major bleeding
  3. 3Transport decision — critical or not? Call for help early
  4. 4Secondary survey — vitals, SAMPLE, OPQRST, head-to-toe
  5. 5Ongoing assessment — reassess and hand over

Same order, every patient, every time. Reassess often.