a neurological scale which gives an objective way of recording conscious

state; originally developed to assess level of consciousness after head

injury its use is now widespread
originally published in 1974 by Jennet
general score correlates with outcome in head injury
GCS is part of several scoring systems including APACHE II, SAPS II & SOFA
that predict outcome in severe illness
its major strengths are that it has proved to be consistent between expert & non-
General:
expert observers and has been adopted worldwide
- GCS has limited applicability (especially in a child below 36 months of age) where
verbal performance of a healthy child would be expected to be poor
General:
Eye responses: - comprise E, V & M (eyes, motor, verbal)
4. spontaneous - originally score was out of 14 with no differentiation between withdrawal and abnormal flexion
3. to speech
2. to pain Eye responses:
1. none 4. eyes open spontaneously
3. eye open to speech (a sleeping person who wakes up scores 4)
Verbal responses: 2. eye opening to pain
5. infant coos or babbles (normal activity) paediatric 1. no eye opening
glasgow coma
4. infant is irritable or cries continually GCS
3. infant cries to pain score Verbal responses:
2. infant moans to pain 5. Orientated
1. no verbal response 4. Disorientated
3. Inappropriate
Motor responses: GCS 2. Incomprehensible
6. infant moves spontaneously or purposefully 1. None
5. infant withdraws from touch
4. infant withdraws from pain Motor responses:
3. abnormal flexion to pain 6. Obeys commands
2. extension to pain 5. Localises (eg hand crosses midline or gets above clavicle to supra-orbital pressure)
1. no motor response 4. Withdraws
3. Abnormal flexion (decorticate response)
2. Extension (decerebrate response)
1. None

Interpretation:
- Severe, GCS 3-8
- Moderate GCS 9-12
- Minor GCS 13-15