Glasgow Coma Scale (GCS)

What this tool does

It sums the three standard GCS domains as widely taught for bedside description of consciousness and as part of trauma/neuro monitoring—not a substitute for imaging, ICP management, or specialist decisions.

Domains (classic adult scale)

• Eye opening: spontaneous, to command, to pain, or none.
• Verbal: oriented conversation through none; aphasia and intubation require contextual interpretation.
• Motor: obeys commands through posturing/none; assess best motor response to standardized painful stimulus when appropriate.

Score

GCS = E + V + M (minimum 3, maximum 15)

References

Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81-84.

Rough severity bands (teaching, not diagnostic)

• Many TBI teaching schemas group GCS 13–15 as mild, 9–12 as moderate, and 3–8 as severe—local definitions and pediatric scales differ.
• Trend (improving vs worsening) often matters as much as a single value.
• Pupils, imaging, oxygenation, and intoxicants change management beyond the numeric total.

Limitations

Does not replace full neuro exam, sedation scoring, or pediatric/modified GCS variants. Verbal score is problematic with intubation, hearing loss, and language barriers; motor testing may be limited by paralysis or amputation.

Acute care context (teaching)

• Low or falling GCS should trigger airway assessment and escalation per institutional pathway (ED, trauma, stroke, ICU).
• Avoid comparing scores obtained under different sedatives or at different stimulation standards.
• Use this page for education and communication support—not as a standalone triage mandate.