Glasgow Coma Scale (GCS) Evaluation Pathway
Note: This document provides a structured summary of the Glasgow Coma Scale (GCS) Evaluation Pathway for educational and reference purposes. The GCS is a standardized tool used to assess the level of consciousness in a person following a traumatic brain injury or other acute medical issues. It is not a substitute for comprehensive neurological assessment.
Evaluate patients with altered mental status, head injury, or other conditions affecting consciousness.
Score the best eye response:
- 4 = Spontaneous
- 3 = To speech
- 2 = To pain
- 1 = No response
Score the best verbal response:
- 5 = Oriented
- 4 = Confused
- 3 = Inappropriate words
- 2 = Incomprehensible sounds
- 1 = No response
Score the best motor response:
- 6 = Obeys commands
- 5 = Localizes to pain
- 4 = Withdraws from pain
- 3 = Flexion to pain (decorticate)
- 2 = Extension to pain (decerebrate)
- 1 = No response
Sum the scores from Eye (E), Verbal (V), and Motor (M) responses (E + V + M).
Minimum score is 3, maximum is 15.
General interpretation:
- 13-15: Mild brain injury
- 9-12: Moderate brain injury
- $\le$ 8: Severe brain injury (often indicates coma)
Note: Interpretation should be made in the clinical context. Factors like sedation, paralysis, intubation, or language barriers can affect the score (document these as “untestable” or note limitations).
Monitor GCS serially to detect changes in neurological status. Manage underlying cause. Implement interventions based on severity (e.g., airway protection for GCS $\le$ 8).
