GLASGOW COMA SCALE

The Glasgow Coma Scale (GCS) is used to objectively describe the extent of impaired
consciousness in all types of acute medical and trauma patients. The scale assesses patients
according to three aspects of responsiveness: eye-opening, motor, and verbal responses.
Reporting each of these separately provides a clear, communicable picture of a patient. The
findings in each component of the scale can aggregate into a total Glasgow Coma Score and its
total score have since been incorporated in numerous clinical guidelines and scoring systems for
victims of trauma or critical illness.
Eye opening has four grades with four being the highest and 1 being the severe score. Grade 3
eyes open to speech, Grade 2 eyes opening in response to stimuli. Next component is the verbal
response having five grades: Grade 5 oriented to time, place, and person, Grade 4 confused,
Grade 3 inappropriate words, Grade 2 Incomprehensible sounds, Grade 1 no response. The last
component is the motor response having six grades: Grade 6 obeys command, Grade 5 localizes
to pain, Grade 4 withdraws from pain, Grade 3 abnormal flexion (decorticate posturing), Grade 2
abnormal extension (decerebrate posturing), Grade 1 no response.

SCORING:
The lowest score for each category is 1, therefore the lowest score in total is 3 (no response to
pain, no verbal response, and no eye opening) A GCS of 8 or less indicates severe brain injury, a
GCS of 9-12 indicates moderate brain injury and a GCS of 13-15 indicates mild brain injury.
Mild brain injuries can result in temporary or permanent neurological symptoms and
neuroimaging tests such as CT scan or MRI may or may not show evidence of any damage.
Moderate and severe brain injuries often result in long-term impairments in cognition (thinking
skills), physical skills, and/or emotional/behavioral functioning