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)
Glasgow Coma Scale  (GCS 3-15)
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    Decorticate posturing
2 decerebrate posturing (extension)  Decerebrate posturing  → 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)

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Glasgow Coma Scale