π§ Glasgow Coma Scale (GCS)
Standardised neurological assessment for trauma, stroke, and critically ill patients.
Used daily by neurosurgeons, emergency physicians, and ICU teams. 100% clientβside, private.
ποΈ Eye opening
π£οΈ Verbal response
πͺ Motor response
π Score 3β15
πΆ Pediatric modification: For children < 5 years, consider the Pediatric GCS (modified verbal and motor responses). This calculator uses the standard adult GCS.
Glasgow Coma Scale Score
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π Severity Classification
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π©Ί Clinical Implications
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π Component Scores
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β οΈ Important: GCS is a neurological assessment tool. It should be used in conjunction with full clinical examination, pupil assessment, and imaging when indicated. βNot testableβ (NT) items should be documented but prevent a total score calculation.
π What is the Glasgow Coma Scale?
The Glasgow Coma Scale (GCS) was introduced in 1974 by Teasdale and Jennett. It is the international standard for assessing level of consciousness after head injury, stroke, or other neurological conditions.
Three components (each scored separately):
- Eye opening (E): Spontaneous (4) β To speech (3) β To pain (2) β None (1)
- Verbal response (V): Oriented (5) β Confused (4) β Inappropriate words (3) β Incomprehensible (2) β None (1)
- Motor response (M): Obeys commands (6) β Localises (5) β Withdraws (4) β Abnormal flexion (3) β Extension (2) β None (1)
Total score: 3 (worst) to 15 (best). βNot testableβ (NT) should be recorded but prevents total scoring.
β¨ Clinical Utility & Interpretation
- GCS 13β15: Mild brain injury. Often observed or admitted for monitoring.
- GCS 9β12: Moderate brain injury. Requires inpatient neuro observation, repeat imaging, possible ICU.
- GCS 3β8: Severe brain injury. Intubation, ICU admission, neurosurgical consultation.
Serial GCS assessments are essential to detect neurological deterioration.
π‘ Pro tip: A drop of β₯ 2 points should prompt urgent reassessment and CT imaging.
β οΈ Important Considerations
- Intubation, sedation, or paralysis invalidate verbal and motor responses. Document βNTβ and use alternative tools like FOUR score.
- Periorbital oedema may prevent eye opening β document as βNTβ.
- Best response is always the highest score observed.
β Frequently Asked Questions
Document verbal and motor responses as βNTβ (not testable). You can still report eye response if not affected. Consider using the FOUR score for patients with severe neurological impairment.
Withdrawal (4) is a purposeful movement away from pain. Abnormal flexion (3, decorticate) is slow, stereotyped flexion of elbows and wrists with extension of legs. Decerebrate extension (2) is stereotyped extension of all limbs.
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