GLASGOW COMA SCALE

Glasgow Coma Scale

Scale rating eye opening, motor response, and verbal response after brain injury; total 3-15 (Teasdale & Jennett, 1974)

GCS total score range

3 (lowest) to 15 (highest)

GCS three categories

Eye opening (1-4), motor response (1-6), verbal response (1-5)

Eye opening 4: Spontaneous

Eyes open, not necessarily aware

Eye opening 3: To speech

Non-specific response, not necessarily to command

Eye opening 2: To pain

Opens eyes to sternum, limb, or supra-orbital pressure

Eye opening 1: None

No eye opening even to supra-orbital pressure

Motor 6: Obeys commands

Follows simple commands

Motor 5: Localizes pain

Arm attempts to remove supra-orbital or chest pressure

Motor 4: Withdrawal

Arm withdraws to pain, shoulder abducts

Motor 3: Flexor response

Withdrawal response or assumption of hemiplegic posture (abnormal flexion/decorticate)

Motor 2: Extension

Shoulder adducted and shoulder and forearm internally rotated (decerebrate)

Motor 1: None

No response to any pain; limbs remain flaccid

Verbal 5: Oriented

Converses and is oriented

Verbal 4: Confused

Converses but is confused and disoriented

Verbal 3: Inappropriate

Intelligible words, no sustained sentences

Verbal 2: Incomprehensible

Moans/groans, no speech

Verbal 1: None

No verbalization of any type

Supra-orbital pressure

Painful stimulus applied over the brow ridge to test response

Sternal pressure

Painful stimulus applied to the sternum (sternal rub)