Glasgow Coma Scale (GCS)

There are many different assessment tools for neurological function, however, the most widely known and used tool is the Glasgow Coma Scale.

The GCS sees a patient assessed and scored in three areas of neurological function:

1. Eye-opening,
2. Verbal response,
3. Motor response.

The highest possible GCS score is a 15, which reflects an individual who is fully alert, aware and orientated.

The lowest possible score is 3, meaning the person is unconscious and unresponsive.

So, let’s look at measuring the person’s eye-opening.

• Do they open their eyes spontaneously, like normal? (4 points.)
• Do they only open their eyes when you speak to them or in response to noises? (3 points.)
• Do they only open their eyes to a physical or painful stimulus? (2 points.)
• Do they not open their eyes to anything? (1 point.)

Verbal response.

• Is the person talking normally? Do they know who they are, where they are and when they are? (5 points.)
• Do they seem confused and unable to answer these questions? (4 points.)
• Do they respond with the wrong word to your questions? (3 points.)
• Is the person making only incomprehensible sounds or moans? (2 points.)
• Is the person not making any noise? (1 point.)

Motor response.

• Are they able to follow a command? (6 points.)
• Do they localise to a spot when a painful stimulus is applied? (5 points.)
• Do they withdraw from the painful stimulus? (4 points.)
• Does the person react with an abnormal flexion? (3 points.)
• Does the person respond with an abnormal extension? (2 points.)
• Do they have no response to painful stimuli? (1 point.)