What is the Glasgow Coma Scale (GCS)?

The Glasgow Coma Scale (GCS) is a clinical tool used to objectively assess a patient's level of consciousness and neurological functioning after a brain injury. It evaluates three aspects of responsiveness: eye opening, verbal response, and motor response. Scores range from 3 to 15, with lower scores indicating more severe impairment.

How is the GCS Score Calculated?

The GCS score is the sum of three components: Eye Opening (E), ranging from 1 (no eye opening) to 4 (spontaneous eye opening), Verbal Response (V), from 1 (no verbal response) to 5 (oriented), and Motor Response (M), from 1 (no motor response) to 6 (obeys commands). The total score is calculated as E + V + M.

ADDONS / SCALES

Glasgow Coma Scale (GCS)

David Goldemund M.D.
Updated on 10/03/2024, published on 20/02/2024

Glasgow Coma Scale (GCS) is an objective and reliable tool for assessing patients´ level of consciousness based on their response to defined stimuli; it is used in acute medical and trauma patients
GCS evaluates three aspects of responsiveness: eye opening (E), verbal response (V), and motor response (M)
- interfering factors must be considered (intubated or aphasic patients, factors such as sedation, alcohol or drug influence)
stimulation used:
- sound: spoken or shouted request
- physical: pressure applied to the fingertip, trapezius, or supraorbital notch
score the highest observed response
the GCS has been incorporated into numerous clinical guidelines and scoring systems
scores range from 3 to 15, with a normal finding being GCS 15 (E4V5M6)

→ Disorders of consciousness

Glasgow Coma Scale (GCS 3-15)
Eye-opening
4	spontaneous
3	to sound (after a spoken or shouted request)
2	to pressure (after fingertip stimulus)
1	none (no opening; no interfering factor)
Motor response
6	obeys commands (obeys 2-part request)
5	localizing pain (brings hand above clavicle to stimulus on head/neck)
4	normal flexion (escape from pain) – rapid, arms away from the body
3	decorticate posturing (abnormal flexion) – arms across chest, forearms rotate, legs extend
2	decerebrate posturing (extension) → more about decorticate and decerebrate posturing here
1	none (no movement in arms/legs, no interfering factor)
Verbal response
5	oriented (correctly gives name, place, and date)
4	confused (not orientated but communicating coherently)
3	words (single intelligible words)
2	sounds (moans/groans only)
1	none (no audible response, no interfering factor)