The Glasgow Coma Scale (GCS) is used to objectively describe the level of consciousness in patients with acute brain injury. It evaluates three responses: Eye Opening, Verbal Response, and Motor Response.
GCS Scoring Criteria
Eye Opening (E) - Max 4 Points
- 4 = Spontaneous eye opening
- 3 = Eye opening in response to sound/command
- 2 = Eye opening in response to pressure/pain
- 1 = No eye opening
Verbal Response (V) - Max 5 Points
- 5 = Oriented to time, place, and person
- 4 = Confused conversation
- 3 = Inappropriate words
- 2 = Incomprehensible sounds
- 1 = No verbal response
Motor Response (M) - Max 6 Points
- 6 = Obeys commands
- 5 = Localizes to pain/pressure
- 4 = Normal flexion/withdrawal from pain
- 3 = Abnormal flexion (decorticate posturing)
- 2 = Abnormal extension (decerebrate posturing)
- 1 = No motor response
Crucial Rule: The minimum GCS score is 3, and the maximum is 15. A score of 8 or less indicates a severe brain injury, and the rule is: 'GCS of 8, Intubate!'
