The Glasgow Coma Scale (GCS) is the

most common scoring system used to

describe the level of consciousness in a
person following a traumatic brain injury.
Basically, it is used to help gauge the
severity of an acute brain injury. The
test is simple, reliable, and correlates
well with outcome following severe
brain injury.
The GCS is a reliable and objective way of
recording the initial and subsequent level of
consciousness in a person after a brain injury.
-It is used by trained staff at the site of an
injury like a car crash or sports injury, for
example, and in the emergency department
and intensive care units.
 Older child to Adult
Eye Opening (E) 4 = spontaneous
3 = to voice
2 = to pain
1 = none

Verbal Response (V) 5 = normal conversation

4 = disoriented conversation
3 = words, but not coherent
2 = no words, only sounds
1 = none

Motor Response (M) 6 = normal

5 = localized to pain
4 = withdraws to pain
3 = decorticate posture
2 = decerebrate
1 = none
 Decorticate posture: (an abnormal posture that
can include rigidity, clenched fists, legs held
straight out, and arms bent inward toward the body
with the wrists and fingers bend and held on the
chest)
Decerebrate: (an abnormal posture that can
include rigidity, arms and legs held straight out,
toes pointed downward, head and neck arched
backwards)
Using the Glasgow Coma Scale
Every brain injury is different, but generally, brain
injury is classified as:
Severe: GCS 3-8 (You cannot score lower than a 3.)
Moderate: GCS 9-12
Mild: GCS 13-15
Mild brain injuries can result in temporary or
permanent neurological symptoms and a neuro-
imaging 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.
Limitations of the Glasgow Coma Scale
Factors like drug use, alcohol intoxication,
shock, or low blood oxygen can alter a
patients level of consciousness. These factors
could lead to an inaccurate score on the GCS.
 Infant to young child

Eye Opening (E) 4 = spontaneous

3 = to voice
2 = to pain
1 = none

Verbal Response (V) 5 = smiles, oriented to sounds, follows objects,

interacts
4 = cries but consolable, inappropriate interactions
3 = inconsistently inconsolable, moaning
2 = inconsolable, agitated
1 = none

Motor Response (M) 6 = moves spontaneously or purposefully

5 = withdraws from touch
4 = withdraws to pain
3 = decorticate posture
2 = decerebrate
1 = none
Pediatric brain injuries are classified by severity using the
same scoring levels as adults, i.e.
3-8 reflecting the most severe
9-12 being a moderate injury
13-15 indicating a mild TBI

As in adults, moderate and severe injuries often result in

significant long-term impairments.