Glasgow Coma Scale (GCS)
Consciousness level by eye opening, verbal response, and motor response. Total range 3–15.
About this calculator
The Glasgow Coma Scale (GCS) is the standard for level-of-consciousness assessment in traumatic brain injury and other acute neurologic states. Developed by Teasdale and Jennett (Lancet, 1974). Three components: eye opening (1-4), verbal response (1-5), motor response (1-6). Sum 3-15. Components. Eyes: 4 – spontaneous, 3 – to sound, 2 – to pain, 1 – none. Verbal: 5 – oriented, 4 – confused, 3 – words, 2 – sounds, 1 – none. Motor: 6 – obeys, 5 – localizes pain, 4 – withdraws, 3 – abnormal flexion (decorticate), 2 – abnormal extension (decerebrate), 1 – none. TBI severity. 13-15 – mild, 9-12 – moderate, 3-8 – severe (intubation indicated for airway protection when reflexes lost and aspiration risk). 3 – deep coma or brain death (needs other confirmatory criteria including angiography or EEG). Clinical use. ED, ICU, neurosurgery. Intubation decision at GCS <=8. Pre-CT stratification per Canadian CT Head Rule and New Orleans. Dynamic monitoring every 30-60 minutes in the first 24 hours after TBI – a 2+ point drop requires immediate neuroimaging and management review. Limitations. In intubated patients the verbal component cannot be assessed – use GCS-T (e.g., 10T for sum of remaining components). In children use the adapted Pediatric GCS. In aphasia, deafness, intoxication, opioid overdose interpretation requires caution. FOUR score (Full Outline of UnResponsiveness) is an alternative in deeply comatose patients with better discrimination below GCS=8.
Source
Formula version: teasdale-jennett-1974-btf-2016-v1
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