Glascow Coma Scale (GCS)

 Eyes

  • 4pt – Open spontaneously
  • 3pt – Open to voice
  • 2pt – Open to pain
  • 1pt – No eye opening

Verbal

  • 5pt – Oriented, normal conversation
  • 4pt – Confused, disoriented
  • 3pt – Incoherent words
  • 2pt – Incomprehensible sounds
  • 1pt – No sounds

Motor

  • 6pt – Obeys command
  • 5pt – Localizes pain
  • 4pt – Withdrawal / flexion to pain
  • 3pt – Flexion to pain (decorticate)
  • 2pt – Extension to pain (decerebrate)
  • 1pt – No movement

 

Head Injury Classificaiton:

  • Minor >13
  • Moderate 9-12
  • Severe  <8
Threshold to consider intubation for airway protection (ATLS) = 8
Intubated patients are given a “t” for verbal, denoted as “GCS 3t”
Use pediatric GCS for patients <2 years old. (pGCS)

References:

  1. CDC Mass Trauma Resources Download PDF
  2. The Glascow Structured Approach to Assessment of the Glascow Coma Scale Link
  3. Life In The Fast Lane (LITFL) – GCS Link

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