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Have you ever been watching a medical, nursing, police, firefighter, paramedic, or hospital-based TV show, or a series on Netflicks, Hulu, or even a movie…

and seen them rushing the patient in through the doors and giving quick report…such as we have a 55 year old male driver that was involved in an MVA, wearing a seatbelt, airbag deployed, unknown if there was any LOC, and with a GCS of 10.

That sounds exciting, but what does all that mean? What are they talking specifically about when they say GCS???

What is a GCS, and what does the number mean???

The beginnings of GCS started all back in the 1970’s.

In 1974, at the University of Glasgow, in Glascow Scotland, two neurosurgery professors Graham

Teasdale and Bryan Jennett, published The Glasgow Coma Scale, also known simply as GCS (for short). Their development revolutionized a way for a quick and objective assessment of a person. Specifically, it was a method to be able to communicate rapidly, the neurological status of a person, by measuring a person's level of consciousness. It does not provide in-depth, detailed information, or a detailed assessment. But it does provide a quick and rapid overview of a patients status. It may be part of a nursing assessment, to be documented in the patient’s medical record.

It is based on 3 measurements of assessments:

Eye-opening responsiveness, Verbal responsiveness, and Motor responsiveness,

The higher the number the more alert and responsive the patient is, the lower the number, the less alert and responsive the patient is.

First…consider what you may (or may not) know about a patient, if possible and available.

A person’s level of consciousness, or LOC, can be altered, and it may not be due to an injury.

Also, medications, prescriptions or otherwise, a prior medical history of paralysis (due to injury, stroke, etc), may interfere with the GCS assessment results.

These categories within the GCS cannot be measured and are described as Not Testable or NT.

These categories are:

Eye Opening Response

If eye opening is Spontaneous = 4 points

If eye opening is To verbal stimuli = 3 points

If eye opening is To pain only = 2 points

If No response = 1 point

Verbal Response

If Oriented to person, place, time and situation = 5 points

If Confused but converses, and able to answer questions = 4 points

If Inappropriate verbal response = 3 points

If Incomprehensible speech = 2 points

If No response = 1 point

Last but not least…

Motor Response

If able to Obey commands for movement = 6 points

If able to provide Purposeful movement to painful stimulus = 5 points

IF withdraws in response to pain = 4 points

If in response to pain Flexion occurs (decorticate posturing) = 3 points

If in response to pain Extension occurs (decerebrate posturing) = 2 points

If No response = 1 point

The overall Total scores in each category are:

Eye opening response

Lowest total score =1 Highest total score = 4 points

Verbal Response

Lowest total score = 1 Highest total score = 5 points

Motor Response

Lowest total score = 1 highest total score = 6 points


Lowest GCS = 3 HIGHEST GSC = 15

LOWEST indicating a high mortality rate.

Highest indicates: Indicated fully awake and responsive.

However, the Total overall GCS score, which is a summation of all the scores would described as :

a GCS of 15;

or described by its individual sections as in E 4, V 5, M 6 (eyes, verbal, motor).

If you would like to download a free GCS resource that I created, I have a link in the description of my GCS YouTube video, that will allow you to download the resource.

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