Definition
The GCS is the summation of scores for eye, verbal, and motor responses. The minimum score is a 3 which indicates deep coma or a brain-dead state. The maximum is 15 which indicates a fully awake patient (the original maximum was 14, but the score has since been modified).
For best eye responses, there are 4 possible scores:
- No eye opening
- Eye opening in response to pain. (i.e., pressure to fingernail bed or sternal rub)
- Eyes opening to speech
- Eyes opening spontaneously
For best verbal response, there are 5 possible scores:
- No verbal response
- Incomprehensible sounds (such as moaning)
- Inappropriate words
- Confused speech
- Oriented
For best motor response, there are 6 possible scores:
- No motor response
- Extension to pain
- Abnormal flexion to pain
- Withdrawal to pain
- Localizes to pain
- Obeys commands
Once the individual eye, verbal, and motor responses are summed, the final score indicates the following level of brain injury:
- Minor, GCS ≥ 13
- Moderate, GCS 9 – 12
- Severe, with GCS ≤ 8
There are also modifications to the score for intubated patients as well as pediatric patients, as their responses may not adequately grade their level of consciousness (i.e. a 6 month old cannot express themselves, nor can an intubated patient).
Keyword history
- 90%/2009
- 94%/2010
- 99%/2012
- 62%/2014
PubMed
- G Teasdale, B Jennett Assessment of coma and impaired consciousness. A practical scale. Lancet: 1974, 2(7872);81-4 [PubMed:4136544]