FIELD REFERENCE
Full criteria & treatment guidance
Report the components
- Give eye / verbal / motor scores in that order, followed by the total. Example: E4 V5 M6 = 15.
- The minimum total is 3, not 0. Use the age-appropriate scoring table.
Adult scoring
| Component | Score → response |
|---|---|
| Eyes | 4 spontaneous · 3 voice · 2 pain · 1 none |
| Verbal | 5 oriented · 4 confused · 3 inappropriate words · 2 incomprehensible sounds · 1 none |
| Motor | 6 follows commands · 5 localizes pain · 4 withdraws from pain · 3 abnormal flexion · 2 extension · 1 none |
Pediatric scoring: age 2 and younger
| Component | Score → response |
|---|---|
| Eyes | 4 spontaneous · 3 sound · 2 pain · 1 none |
| Verbal | 5 smiles/coos, tracks or interacts appropriately · 4 irritable crying/inappropriate interaction · 3 cries with pain · 2 inconsolable or moans with pain · 1 none |
| Motor | 6 purposeful spontaneous movement · 5 withdraws from touch · 4 withdraws from pain · 3 abnormal flexion · 2 extension · 1 none |
Use a reproducible report
- Record eye, verbal, and motor components separately so a later clinician can distinguish a change in one response from a change in another. Add the total after the components.
- Use the pediatric descriptors for age 2 and younger; infant interaction and purposeful movement differ from the adult verbal/command tasks.
Connect the score with the clinical pathway
- A GCS below 13 is one of four qualifying findings in the adult suspected-sepsis criteria; infection plus at least two findings is required. GCS alone does not diagnose sepsis.
- In adult traumatic brain injury, SO-T-005 directs establishing the airway by the most appropriate available means at GCS 8 or below, with concurrent oxygenation, ETCO₂, and blood-pressure management. Interpret the score with the rest of the patient’s assessment.
VISUAL FIELD REFERENCE
Report E + V + M, then the total
Adult & pediatric · Assessment
Adult descriptors · Total 3–15. Use the separate pediatric table for age 2 and younger.
- E · 1–4
Eye response
4 spontaneous · 3 voice · 2 pain · 1 none
- V · 1–5
Verbal response
5 oriented · 4 confused · 3 inappropriate words · 2 incomprehensible sounds · 1 none
- M · 1–6
Motor response
6 follows commands · 5 localizes pain · 4 withdraws from pain · 3 abnormal flexion · 2 extension · 1 none
- The minimum total is 3, not 0. Use the age-appropriate scoring table.
- Use the pediatric descriptors for age 2 and younger; infant interaction and purposeful movement differ from the adult verbal/command tasks.
Selected checkpoints; read the complete guide for criteria, exclusions, doses, and ongoing care. PR-002 · SO-M-055 · SO-T-005
UNDERSTAND THE CARE
Why the components are more useful than a total alone
The total compresses three observations into one number. Two patients can have the same total with different patterns of impairment, and a change in one component can be hidden by reporting only the sum. State the observed response and the component score so another clinician can understand what changed.
Applying the guidance
Use the age-appropriate table. A young child’s interaction and movement cannot be judged simply by whether the child performs an adult verbal task. Record the time and clinical context of each assessment and connect the findings to the applicable condition pathway. The score contributes to decisions but does not independently diagnose a cause of altered consciousness.
Putting it together
Teaching example: the receiving team hears “GCS 12.” Adding the eye, verbal and motor scores and the prior examination makes it possible to identify which response deteriorated and when.
Diagram text & teaching checkpoints
- Eyes
- Describe and score the observed response.
- Verbal
- Use age-appropriate descriptors.
- Motor
- Record the best applicable response.
- Trend
- Report components, total and time.
Sources for this explanation
Original OCMedic teaching synthesis of the references below. Educational expansion updated ; this is not a new independent clinical-review date. Source-specific dates and limitations remain in the full guidance.
When a response cannot be tested
Intubation, language or hearing barriers, pre-existing deficits, sedation and paralysis can interfere with a component of the examination. Describe the barrier and what you could actually observe; an untestable response is different from an observed absence of response.
The Glasgow Coma Scale structured-assessment guidance uses NT (not testable) for an unavailable component, rather than inventing a score of 1 or 0. It advises against reporting a numerical total when a component is not testable. Continue communicating the assessable eye, verbal or motor findings and their trend. Follow the applicable OC-MEDS documentation process while making the limitation clear in the narrative and handoff.
Teaching example: an intubated patient opens the eyes and follows commands. Report those observed components and why verbal response cannot be tested; a total created by assigning an artificial verbal score can misrepresent the examination. This explanation does not change the OCEMS age-specific scoring table or treatment thresholds above.
Assessment reference: Glasgow Coma Scale: interfering factors and missing information.