Glasgow Coma Scale

The Glasgow coma scale is used to assess patients in a coma. The initial score correlates with the severity of brain injury and prognosis. The Glasgow Coma Scale provides a score in the range 3-15; patients with scores of 3-8 are usually said to be in a coma.

For adults the scores are as follows:

Eye Opening Response	Spontaneous--open with blinking at baseline	4 points
	Opens to verbal command, speech, or shout	3 points
	Opens to pain, not applied to face	2 points
	None	1 point
Verbal Response	Oriented	5 points
	Confused conversation, but able to answer questions	4 points
	Inappropriate responses, words discernible	3 points
	Incomprehensible speech	2 points
	None	1 point
Motor Response	Obeys commands for movement	6 points
	Purposeful movement to painful stimulus	5 points
	Withdraws from pain	4 points
	Abnormal (spastic) flexion, decorticate posture	3 points
	Extensor (rigid) response, decerebrate posture	2 points
	None	1 point

For children under 5, the verbal response criteria are adjusted as follows:

2 to 5 Yrs	Score	0 TO 23 Mos.	Score
Appropriate words or phrases	5	Smiles or coos appropriately	5
Inappropriate words	4	Cries and consolable	4
Persistent cries and/or screams	3	Persistent inappropriate crying &/or screaming	3
Grunts	2	Grunts or is agitated or restless	2
No response	1	No response	1

Glasgow coma scale = Score for eye opening + score for best verbal response + score for best motor response

Interpretation:

Maximum score is 15 which has the best prognosis
Minimum score is 3 which has the worst prognosis
Scores of 8 or above have a good chance for recovery
Scores of 3-5 are potentially fatal, especially if accompanied by fixed pupils or absent oculovestibular responses
Young children may be nonverbal, requiring a modification of the coma scale for evaluation