The Glasgow Goma Scale (GCS) contains 3 components which are eye opening, verbal response and best motor response.
The lowest possible GCS score is 3 and highest possible score is 15. The GCS should be assessed during the primary survey under “DISABILITY” of the ABCDE approach. The suffix NT is allocated to any component that is non testable.
Eye Opening:
4 – opens eyes spontaneously
3 – eyes open to sound
2 – eyes opened to pressure applied on the nail bed for 10 seconds
1 – eyes are not opening to any stimuli and
NT – eye opening responses untestable.
Verbal Response (5):
5 Orientated with Person, Place and Month,
4 – confused (speaking phrases and incomplete sentences,
3 – Words only,
2 – Sounds only and
1 – nil verbal response
Best Motor response (6):
6 – Obeys commands (protrudes tongue, grasp finger)
5 – Localizes pain
4 – Normal flexion (Rapid elbow flexion away from the body)
3 – Abnormal flexion (Slow elbow flexion medial towards the body)
2 – Extension (Slow elbow extension)
1 – Nil motor response
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