Glasgow Coma Scale/Score
Calculates GCS based on Eye (4), Verbal (5), and Motor (6) criteria.

Best Eye Response

  •  Not assessable (Trauma, edema, etc) (C)
  • 4 Eyes open spontaneously. +4
  • 3 Eye opening to verbal command. +3
  • 2 Eye opening to pain. +2
  • 1 No eye opening. +1

Best Verbal Response

  •  Intubated. (T)
  • 5 Oriented. +5
  • 4 Confused. +4
  • 3 Inappropriate words. +3
  • 1 No verbal response. +1
  • 2 Incomprehensible sounds. +2

Best Motor Response

  • 6 Obeys commands. +6
  • 5 Localizes pain. +5
  • 4 Withdrawal from pain. +4
  • 3 Flexion to pain. +3
  • 2 Extension to pain. +2
  • 1 No motor response. +1


The Glasgow Coma Scale (GCS) is the most common scoring system used to describe the level of consciousness in a person following a brain injury. Basically, it is used to help gauge the severity of an acute brain injury either by trauma or medical cause. The test is simple, reliable, and correlates well with outcome following severe brain injury.

The GCS is a reliable and objective way of recording the initial and subsequent level of consciousness in a person. It is used by trained staff at the site of an injury like a car crash or medical emergency, for example, and in the emergency department and intensive care units. The GCS was initially used to assess the LOC in  head trauma patient mainly but the incredible usefulness made it apparent pretty quick that the GCS could and would be effective to assess the overall LOC in essentially any adult patient in the pre-hospital and ED environment. It was considered to be ineffective for the very young patient and initiated the creation of an age appropriate version for toddlers and infants.The Pediatric Glasgow Coma Scale (PGCS), a modification of the scale used on adults, is used instead. The PGCS still uses the three tests eye, verbal, and motor responses and the three values are considered separately as well as together.

Here is the slightly altered grading scale for the PGCS:

Eye Opening (E)

  • 4 = spontaneous
  • 3 = to voice
  • 2 = to pain
  • 1 = none

Verbal Response (V)

  • 5 = smiles, oriented to sounds, follows objects, interacts
  • 4 = cries but consolable, inappropriate interactions
  • 3 = inconsistently inconsolable, moaning
  • 2 = inconsolable, agitated
  • 1 = none

Motor Response (M)

  • 6 = moves spontaneously or purposefully
  • 5 = withdraws from touch
  • 4 = withdraws to pain
  • 3 = decorticate posture (an abnormal posture that can include rigidity, clenched fists, legs held straight out, and arms bent inward toward the body with the wrists and fingers bend and held on the chest)
  • 2 = decerebrate (an abnormal posture that can include rigidity, arms and legs held straight out, toes pointed downward, head and neck arched backwards)
  • 1 = none

Pediatric brain injuries are classified by severity using the same scoring levels as adults, i.e. 3-8 reflecting the most severe, 9-12 being a moderate injury and 13-15 indicating a mild TBI. As in adults, moderate and severe injuries often result in significant long-term impairments.



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