Part of the difficulty of medicine is turning the qualitative into the quantitative, so various physicians have come up with rating or scoring scales to try to make one able to compare one patient’s state to another. I’ve been reviewing a number of these recently, so I thought I’d start a collection. Feel free to add your favorites.

Pulse Scoring

Pulses are rated on a scale ranging from 0 (not palpable) to 2+ (normal). In the event that the pulse is not palpable, the doppler signal generated is also rated, ranging again from 0 to 2+.

Edema Scoring

1+ Mild pitting, slight indentation, no perceptable swelling of the leg
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains for a short time, leg looks swollen
4+ Very deep pitting, indentation lasts a long time, leg is very swollen

Strength Scoring

5/5 Normal strength: movement against gravity with full resistance
4/5 Movement against gravity and some resistance
3/5 Movement against gravity only
2/5 Movement with gravity eliminated
1/5 Visible/palpable muscle contraction, but no movement
0/5 No contraction

Glasgow Coma Scale

I. Motor Response
6 – Obeys commands fully
5 – Localizes to noxious stimuli
4 – Withdraws from noxious stimuli
3 – Abnormal flexion, i.e. decorticate posturing
2 – Extensor response, i.e. decerebrate posturing
1 – No response
II. Verbal Response
5 – Alert and Oriented
4 – Confused, yet coherent, speech
3 – Inappropriate words, and jarbled phrases consisting of words
2 – Incomprehensible sounds
1 – No sounds
III. Eye Opening
4 – Spontaneous eye opening
3 – Eyes open to speech
2 – Eyes open to pain
1 – No eye opening
Glascow Coma Scale = I + II + III.
A lower score indicates a deeper coma and a poorer prognosis.

Deep Tendon Reflexes

0: absent reflex
1+: trace, or seen only with reinforcement
2+: normal
3+: brisk
4+: nonsustained clonus (i.e., repetitive vibratory movements)
5+: sustained clonus

Heart Murmur Grading

Grade 1 = very faint
Grade 2 = quiet but heard immediately
Grade 3 = moderately loud
Grade 4 = loud
Grade 5 = heard with stethoscope partly off the chest
Grade 6 = no stethoscope needed

Apgar Score for Newborns

Color
All pink (2 points)
Blue extremities/pink body (1 points)
Blue/pale (0 points)
Heart rate
over 100 (2 points)
less than 100 (1 points)
Absent (0 points)
Respirations
Good/crying (2 points)
Irregular/slow (1 points)
Absent (0 points)
Response to nose catheter
Sneeze/cough (2 points)
Grimace (1 points)
None (0 points)
Muscle tone
Active (2 points)
Some extremity flexion (1 points)
Limp (0 points)

Mallampati Airway Score

Class 1: Can see PUSH Pillars Uvula Soft Palate Hard Palate
Class 2: Can see USH Uvula Soft Palate Hard Palate
Class 3: Can see SH Soft Palate Hard Palate
Class 4: Can see H Hard Palate

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