PatientPlus articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.
This gives a reliable, objective way of recording the conscious state of a person. It can be used by medical and nursing staff for initial and continuing assessment. It has value in predicting ultimate outcome. Three types of response are independently assessed and are recorded on an appropriate chart (and the overall score is made by summing the scores).
The calculator has been adapted to estimate the Glasgow verbal score from the Glasgow eye and motor scores in intubated patients.
There is a Paediatric Glasgow Coma Scale applicable to infants too young to speak - and the equivalent infant responses are given in the various sections below.
The calculator above has been adapted from The Lancet, Vol 2 (7872) Teasdale G, Jennett B; Assessment of coma and impaired consciousness. A practical scale. pp81-4. ©1974 with permission from Elsevier. The calculator also provides calculated scores for intubated patients using linear regression as described in Meredith W, Rutledge R, Fakhry SM, et al; The conundrum of the Glasgow Coma Scale in intubated patients: a linear regression prediction of the Glasgow verbal score from the Glasgow eye and motor scores. J Trauma. 1998 May; 44(5):839-44.
Some centres score GCS out of 14, not 15, omitting 'withdrawal to pain'. As well as the total figure, the GCS can be expressed as subscores: GCS=15; M6, V5, E4 (motor, verbal and eye-opening responses)
Abbreviated coma scale (AVPU)
This is sometimes used in the initial assessment ('primary survey') of the critically ill.
- A = alert
- V = responds to vocal stimuli
- P = responds to pain
- U = unresponsive
Further reading & references
- Teasdale G, Jennett B; Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974 Jul 13;2(7872):81-4.
- Meredith W, Rutledge R, Fakhry SM, et al; The conundrum of the Glasgow Coma Scale in intubated patients: a linear regression prediction of the Glasgow verbal score from the Glasgow eye and motor scores. J Trauma. 1998 May;44(5):839-44; discussion 844-5.
- Children's Coma Scale (Modified Glasgow Coma Scale, Adelaide Coma Scale, Paediatric Coma Scale)
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Dr Huw Thomas
Dr Hayley Willacy
Dr Colin Tidy