GCS

• Components of GCS:

  • Eye-opening (E): maximum score of 4
  • Verbal response (V): maximum score of 5
  • Motor response (M): maximum score of 6
• Eye opening (E):

  • Eyes opening spontaneously - 4 points
  • Eyes opening to sound (voice) - 3 points
  • Eyes opening to pain - squeeze finger tip or trapezius, or pressure to supraorbital notch - 2 points
  • No response - 1 point
  • Not testable (NT) - if patient cannot open their eyes e.g. oedema, trauma, dressings
• Verbal response (V):

  • Orientated response - able to answer questions appropriately - 5 points
  • Confused conversation - able to reply but confused response - 4 points
  • Inappropriate words - random words unrelated to question - 3 points
  • Incomprehensible sounds - e.g. groans - 2 points
  • No response - 1 point
  • NT - e.g. intubated
• Motor response (M) should be scored based on the highest scoring response you were able to elicit in any single limb e.g. if they were unable to move their right arm but able to obey commands with their left arm, they would score 6 points
• What is the highest score for motor response in the assessment?

  6 points
• What does a score of 5 points indicate in motor response assessment?

  Localises to pain with attempts to reach towards the site of pain
• What is the score for a normal flexion response to pain?

  4 points
• What characterizes an abnormal flexion response to pain?

  Adduction of the arm, internal rotation of the shoulder, flexion of the elbow, pronation of the forearm, and wrist flexion
• What is the score for decorticate posturing?

  3 points
• What does decerebrate posturing indicate in terms of motor response?

  Head extended, arms and legs extended and internally rotated, appearing rigid with teeth clenched
• What is the score for decerebrate posturing?

  2 points
• What score indicates no response in motor response assessment?

  1 point
• What are the different scores and their corresponding motor responses?

  • 6 points: Obeys commands
  • 5 points: Localises to pain
  • 4 points: Withdraws to pain (normal flexion response)
  • 3 points: Abnormal flexion response (decorticate posturing)
  • 2 points: Abnormal extension (decerebrate posturing)
  • 1 point: No response