Sign | Glasgow Coma Scale[1] | Pediatric Glasgow Coma Scale[2] | Score |
Eye opening | Spontaneous | Spontaneous | 4 |
To command | To sound | 3 | |
To pain | To pain | 2 | |
None | None | 1 | |
Verbal response | Oriented | Age-appropriate vocalization, smile, or orientation to sound; interacts (coos, babbles); follows objects | 5 |
Confused, disoriented | Cries, irritable | 4 | |
Inappropriate words | Cries to pain | 3 | |
Incomprehensible sounds | Moans to pain | 2 | |
None | None | 1 | |
Motor response | Obeys commands | Spontaneous movements (obeys verbal command) | 6 |
Localizes pain | Withdraws to touch (localizes pain) | 5 | |
Withdraws | Withdraws to pain | 4 | |
Abnormal flexion to pain | Abnormal flexion to pain (decorticate posture) | 3 | |
Abnormal extension to pain | Abnormal extension to pain (decerebrate posture) | 2 | |
None | None | 1 | |
Best total score | 15 |
The Glasgow Coma Scale (GCS) is scored between 3 and 15, with 3 being the worst and 15 the best. It is composed of 3 parameters: best eye response (E), best verbal response (V), and best motor response (M). The components of the GCS should be recorded individually; for example, E2V3M4 results in a GCS of 9. Traditionally, the GCS defines the severity of traumatic brain injury (TBI) as follows: ≤8: severe brain injury, 9 to 12: moderate injury, and a score ≥13 or higher: mild injury. However, a significant minority of patients with TBI and a GCS score of 13 have potentially life-threatening intracranial lesions. While a revised classification has not been widely adopted, a GCS score of 9 through 13 likely best represents the TBI population at moderate risk for death or long-term disability (ie, "potentially severe").
The Pediatric Glasgow Coma Scale (PGCS) was validated in children 2 years of age or younger.Do you want to add Medilib to your home screen?