π§ Glasgow Coma Scale (GCS): How to Score It Fast and Never Forget It
Whether it's a trauma code, neurology shelf, or Step 2 CK clinical vignette, you're expected to know how to calculate a GCS score in seconds. This post will help you lock down the three categories, the point system, and the most useful mnemonics and clinical triggers for scoring patients correctly.
π§ͺ What is GCS?
The Glasgow Coma Scale is used to assess level of consciousness in trauma and neurologic patients. Itβs a quick, objective tool across three categories:
Eye Opening (E)
Verbal Response (V)
Motor Response (M)
Total score: 3 (lowest) to 15 (best)
π§ GCS Breakdown Table
Eye Opening (E)
Response | Points | Description |
---|---|---|
Spontaneous | 4 | Opens eyes without stimulus |
To voice | 3 | Opens eyes to verbal command |
To pain | 2 | Opens eyes to painful stimulus only |
None | 1 | No eye opening |
Verbal Response (V)
Response | Points | Description |
---|---|---|
Oriented | 5 | Correct place, time, and self |
Confused | 4 | Converses but disoriented |
Inappropriate words | 3 | Random or exclamatory speech, no conversation |
Incomprehensible sounds | 2 | Moaning, no words |
None | 1 | No verbal response |
Motor Response (M)
Response | Points | Description |
---|---|---|
Obeys commands | 6 | Follows verbal instructions |
Localizes pain | 5 | Purposeful movement toward pain |
Withdraws | 4 | Pulls limb away from painful stimulus |
Flexion (decorticate) | 3 | Abnormal flexion to pain |
Extension (decerebrate) | 2 | Abnormal extension to pain |
None | 1 | No motor response |
π‘ Mnemonic: βEyes 4, Verbal 5, Motor 6β
Each section maxes at 4, 5, and 6 respectively
Total = E + V + M (3 to 15)
π§ KOTC Tip: If GCS β€ 8 β intubate on Step 2 CK and trauma algorithms
π Clinical Pearls
A GCS of 15 does not rule out brain injury (e.g., concussion)
A GCS of 3 = coma or brain death
Pediatric GCS exists but is NOT often tested on USMLE
Combine with Glasgow score + vital signs for trauma decision-making
π KOTC clinical flashcards include GCS audio + visual cases with score predictions
π Before You Goβ¦
Remember: if GCS is low, your clinical reasoning should be high.
β Call-to-Action (CTA)
Use KOTCβs neuro-visuals, trauma simulators, and scoring calculators to master neuro status assessment.
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Frequently Asked Questions (FAQs)
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Aim for 4-6 focused hours, ensuring you incorporate breaks to avoid burnout.
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Practice mindfulness techniques, take practice exams under realistic conditions, and maintain a balanced lifestyle.
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Set short-term goals, seek support from mentors, and reward yourself for small achievements.
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Regular exercise improves focus, reduces stress, and enhances overall mental clarity.
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KOTC offers personalized learning tools, gamification features, and adaptive question banks to help students stay on track without burnout.