Glasgow Coma Scale

Background

  • Abbreviation: GCS

Scoring

Adult GCS

Eye Opening Verbal Motor
6: Obeys commands
5: Oriented5: Localizes to pain
4: Spontaneously opens4: Confused speech4: Withdraws from pain (normal flexion)
3: Opens to command3:Inappropriate words3: Decorticate posturing (abnormal flexion)
2: Opens to pain2: Incomprehensible sounds2: Decerebrate posturing (extension)
1: Does not open1: No response1: No response
  • 14-15: Mild
  • 9-13: Moderate
  • 3-8: Severe

Pediatric GCS[1][2]

Eye Opening Verbal Motor
6: Normal spontaneous movement
5: Smiles, coos, babbles5: Withdraws to touch
4: Opens eyes spontaneously4: Irritable, crying (but consolable)4: Withdraws to pain
3: Opens eyes to speech only3:Inconsolable crying or crying only in response to pain3: Abnormal flexion to pain (Decorticate response)
2: Opens eyes to pain only2: Moans in response to pain2: Abnormal extension to pain (Decerebrate response)
1: Does not open eyes1: No response1: No response

Note:

  • For Motor score 4, pain is defined flat, fingernail pressure (often performed with the barrel of a pencil).
  • For Motor scores 2 and 3, pain is defined by pressing hard on the supraorbital notch. If this unsuccessful, sternal pressure may also be attempted.

See Also

References

  1. Holmes JF, Palchak MJ, MacFarlane T, et al. Performance of the pediatric glasgow coma scale in children with blunt head trauma. Acad Emerg Med. 2005 Sep;12(9):814-9.
  2. James HE. Neurologic evaluation and support in the child with an acute brain insult. Pediatr Ann. 1986 Jan;15(1):16-22.
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