Neurologic assessment
Glasgow Coma Scale (Adult)
The GCS measures the level of consciousness after brain injury. Select the best response in each domain to compute the total score (3–15).
Eye opening (E)
Verbal response (V)
Motor response (M)
Component scores
- E: 4
- V: 5
- M: 6
Total GCS
15
Range 3–15
Scores 13–15 are considered mild, but repeat assessments are essential to detect deterioration.
Document trends; a drop of ≥2 points is clinically significant and warrants urgent reassessment.
How to Use This Calculator
Assess each domain individually
Apply maximal stimulation needed for eye, verbal, and motor responses before recording the best reaction.
Account for confounders
Note factors such as intubation, sedation, or aphasia. Use modifiers (e.g., V1T) in clinical documentation.
Trend over time
Repeat assessments to detect deterioration. Combine with pupil response and vital signs for neurocritical care decisions.
Formula
GCS total = Eye response (E, 1–4) + Verbal response (V, 1–5) + Motor response (M, 1–6).
Minimum score 3 (E1 V1 M1); maximum 15 (E4 V5 M6).
Severity classification: Severe ≤8, Moderate 9–12, Mild 13–15.
Full Description
The Glasgow Coma Scale (1974) standardizes neurologic assessment after traumatic brain injury. It measures arousal (eye opening) and cortical function (verbal and motor responses). The motor score correlates best with outcome, while the total score aids triage, prognosis, and communication between teams.
Use pediatric modifications for infants, and consider adjuncts such as brainstem reflexes (FOUR score) when intubation precludes verbal scoring. Document intubated patients as V1T and sedated cases with the best attainable response prior to sedation. Trends are more informative than a single measurement.
Frequently Asked Questions
How do I score an intubated patient?
Assign V1 and note inability to verbalize (e.g., V1T). The total score is still reported but always document modifiers.
What if sedation limits responsiveness?
Use the best GCS prior to sedation and indicate the level of sedation (e.g., RASS). Reassess once sedation is lightened.
Is the GCS reliable for stroke patients?
It is widely used but limited for focal deficits. Combine with NIH Stroke Scale or other neurologic tools for comprehensive evaluation.
Does a higher score guarantee good outcome?
No. GCS is one component of prognosis. Age, imaging findings, pupils, and systemic injuries also influence outcomes.