DOCTOR INFORMATION

Glasgow Coma Scale


Eye-opening πŸ‘

 


Action
GCS Score
Spontaneous eye-opening πŸ‘
Open their eyes with no prompting 
4
Eye-opening in response to sound πŸ‘
β€œcan you hear me❓”
3
Eye-opening in response to pain πŸ‘
pressure on fingertips, trapezius squeeze, pressure on supraorbital notch 
2
No eye opening πŸ‘
Do not open eyes at all βŒ
1
Not testable πŸ‘
trauma prevents them opening their eyes βŒ
NT



Verbal response 

Ask❓:



Action
GCS Score
Orientated response 
Appropriate responses βœ…
5

Confused conversation 


Patient responds but seems confused❓
4
Inappropriate words 
Patient says random words that do not answer the question❓
3
Incomprehensible noises 
Patient is making sounds not saying words 
2
No response 
No words or sounds βŒ
1
Not testable 
Incubation prevents them from making any sound βŒ
NT


Motor Response 



Score the patient according to their highest score, obtained from any limb:

 


Action
GCS Score
Obeys command 
Patient performs 2 step command e.g. β€œlift arm and make fist” 
6
Localises to pain 
Patient attempts to reach towards site of pain e.g. trapezius squeeze/pressure on supraorbital notch βœ‹
5
Withdraws from pain 
Patient flexes arm rapidly at elbow, attempting to move away from pain 
4
Abnormal flexion response to pain 
Decorticate posture: stiff, straight legs, clenched fists on the chest as the arms are bent (shown below), indicates significant brain damage πŸ§ 
3
Abnormal extension response to pain 
Decerebrate posture: straight arms and legs with pointed toes and arched back head (shown below), indicates brain stem damage πŸ§ 
2
No response 
No motor response to pain βŒ
1
Not testable 
e.g. paralysis prevents motor response βŒ
NT



Completion βœ…



Add the patient’s 3 scores together to calculate their GCS Score 

Document the breakdown of scores βœ

The highest possible score is 15 indicating that the patient is fully conscious β¬†

The lowest possible score is 3 indicating that the patient is either dead or in a coma β¬‡


Related Articles
This step by step guide is designed to take you through the Cerebellar Examination in OSCEs.
This step by step guide is designed to take you through performing cardiopulmonary resuscitation (CPR) in a hospital for the OSCEs.
About the author

The i-medics Editorial Team consists of Doctors, Medical Students, Professional Content writers, i-medics Ambassadors and Freelance workers.