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Glasgow Coma Scale

The GCS is a quick rating of neurological status based on three components: state of consciousness (based on eyes being opened and tracking events), state of motor control (based on responses to verbal commands and (if nonresponsive to instructions) responses to painful stimuli, and state of langauge functioning (oriented and able to meanfully answer questions)

Eyes–Open:

  • 4 Spontaneously
  • 3 To Verbal Command
  • 2 To Pain
  • 1 No response

Best Motor Response–To Verbal Command:

  • 6 Obeys

To Painful Stimulus:

  • 5 Localizes Pain
  • 4 Flexion–Withdrawal
  • 3 Flexion-Abnormal
  • 2 Extension
  • 1 No response

Best Verbal Response

  • 5 Oriented and Converses
  • 4 Dieoriented and Converses
  • 3 Inappropriate Words
  • 2 Incomprehensible Sounds
  • 1 No response

The GCS Total Score ranges from 3 to 15; this is the variable most typically reported and studied.

Categorization:

  • Coma: No eye opening, no ability to follow commands, no word verbalizations (3-8)

Head Injury Classification:

  • Severe Head Injury—-GCS score of 8 or less
  • Moderate Head Injury—-GCS score of 9 to 12
  • Mild Head Injury—-GCS score of 13 to 15

(Adapted from: Advanced Trauma Life Support: Course for Physicians, American College of Surgeons, 1993).

Glasgow Coma Scale–Summary

Eyes
Best Motor Response
Best Verbal Response

GCS Total 3-15

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