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Glasgow Coma Scale (GCS)

GCS Audit

Consciousness Baseline

Neuro-Behavioral Audit

Eye Opening (E)

Verbal (V)

Motor Response (M)

Clinical Axiom

The GCS is not a static score. Monitoring for "GCS Drops" is the primary method of detecting acute neurological decline.

Neurological Sentinel Probe

Assess components of the Glasgow Coma Scale (E, V, M) to establish a baseline for intracranial integrity and consciousness level.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Any patient with impaired or altered consciousness — traumatic or non-traumatic aetiology

Acute traumatic brain injury (TBI) — initial triage, severity classification, and serial monitoring

Non-traumatic causes: metabolic encephalopathy, DKA, endocrine crises, CO poisoning, severe intoxication

Subarachnoid haemorrhage — incorporated into WFNS grading scale

ICU monitoring — component of APACHE II and SOFA scores

Guiding airway decisions: GCS ≤ 8 indicates high risk of airway compromise; intubation strongly considered

Prehospital triage and inter-facility transfer decisions

When NOT to Use

Patients under neuromuscular blockade — scale is invalid; do not score

Active deep sedation — score is unreliable; assess before sedating where possible

Isolated spinal cord injury or cauda equina — arousability/awareness are unaffected

Differentiating disorders of consciousness (vegetative vs. minimally conscious state) — GCS was not designed for this; FOUR score or specialist assessment preferred

Note: GCS can still be applied in intoxication, but with caution — impaired consciousness should be attributed to brain injury until excluded

Last Comprehensive Review: 2026

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ABCD2 Score

MoCA

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