Glasgow Coma Scale

Introduction

The Modified Glasgow Coma Scale (GCS) (the 15-point scale) is a commonly used scoring system for determining impaired consciousness in both traumatic and non-traumatic presentations.

15-Point Scale

3 behavioural aspects are independently measured and used alongside a composite score to rate a person's overall level of consciousness.

• Eye-opening response
• Verbal response
• Motor response

Interpretation

A lower GCS score indicates a more severe loss of consciousness; the lowest score of 3 indicates a patient who is totally unresponsive.

• GCS score 8 or less: severe brain injury (usually said to be in a coma)
• GCS score 9-12: moderate brain injury
• GCS score 13-15: mild (minor) brain injury.

It is clinically important to provide the individual scores in addition to the total score e.g. GCS of 10 with E3, V3 and M4.

Limitations

It is not suitable for use when assessing children, especially those under 3 years old who are too young to have reliable language skills.

External Links

• Glagow Coma Scale
  
• Assessment of coma and impaired consciousness. A practical scale, 1974
  
• MDCalc - Glasgow Coma Scale/Score (GCS)