Glasgow Coma Scale calculator
Pick the three responses, get the GCS total and severity band.
Educational tool, not medical advice. Do not use this page to make decisions about a patient’s care. Scoring a real patient needs trained assessment. If someone may have a head injury or is hard to wake, call emergency services (911 in the US). How we check our calculators.
What is the Glasgow Coma Scale?
The Glasgow Coma Scale (GCS) is a bedside scale that describes how awake and responsive a person is after a brain injury or other cause of reduced consciousness. It was introduced by Graham Teasdale and Bryan Jennett of Glasgow in a 1974 paper in The Lancet, “Assessment of coma and impaired consciousness: a practical scale,” to replace vague words such as “stuporous” with something every examiner could score the same way. It has three parts: eye opening (1 to 4), verbal response (1 to 5) and motor response (1 to 6). The total runs from 3 (deep unresponsiveness) to 15 (fully awake and obeying).
How is the score read?
For traumatic brain injury a total of 13 to 15 is called mild, 9 to 12 moderate and 3 to 8 severe; these are the bands used in the CDC’s Report to Congress on mild traumatic brain injury. The bands are conventions, and some authors place a score of 13 in the moderate group, so check which convention a document uses. Example: eyes opening to sound (E3), confused speech (V4) and localizing to pressure (M5) add up to 12, which falls in the moderate band.
Why do clinicians report the three parts, not just the total?
Different combinations give the same sum. A total of 8 can be E2 V2 M4 or E1 V3 M4, and they describe different patients. The authors of the scale make this point in their 2014 review for its 40th anniversary: individual patients are best described by the three components, while the total score should be used to characterize groups, and predictions should only be made together with other variables in a multivariate model. A part that cannot be tested, for example because the eyes are swollen shut or the patient is intubated, is recorded as “NT”, and no total is given. This calculator follows that rule.
What is the GCS-Pupils score?
In 2018 Brennan, Murray and Teasdale proposed a simple extension: subtract from the GCS the number of pupils that do not react to light (0, 1 or 2). The result, called GCS-P, runs from 1 to 15. Using data from 15,900 patients in the CRASH and IMPACT studies, they found it carried more information about outcome than the GCS alone, and about as much as more complicated combinations. At a GCS of 3, mortality was 51% and unfavorable outcome 70%; at a GCS-P of 1 (which can only be a GCS of 3 with both pupils unreactive) they were 74% and 90%. In the example above, one unreactive pupil turns a GCS of 12 into a GCS-P of 11. Choose the pupil option in the form to see it.
Can this be used for children?
Not on its own. The verbal part depends on speech, which babies and toddlers cannot give, so modified pediatric versions of the scale exist for young children. This page uses the adult descriptors and does not offer a pediatric version; do not use it for infants or small children.
What can make the score misleading?
Sedatives, alcohol and other drugs, a breathing tube, facial swelling and deafness can lower a part of the score without reflecting the brain injury. The 2014 review calls for consensus on how to deal with these confounders. The score is also a snapshot: a single value says little, whereas a trend over minutes and hours is what clinicians watch.
Is a score of 3 the same as brain death?
No. A GCS of 3 means no eye opening, no verbal sound and no motor response to stimulus at that moment. The CRASH and IMPACT data above show that 51 percent died in that group, so about half did not. Brain death is a separate clinical and legal determination with its own criteria.
How each part is scored
Eye opening: 4 spontaneous, 3 to sound (a spoken or shouted request), 2 to pressure, 1 none. Verbal: 5 oriented, 4 confused, 3 words only (random or inappropriate), 2 sounds only, 1 none. Motor: 6 obeys commands, 5 localizes the pressure, 4 normal flexion (withdrawal), 3 abnormal flexion, 2 extension, 1 none. The wording follows the descriptors on the official Glasgow Coma Scale website (glasgowcomascale.org). Examiners score the best response they can obtain.
Limits of this tool
A real examination needs a trained person, a stimulus applied in the standard way, and a judgment about confounders; no calculator can supply any of that. The tool adds numbers and applies the published bands. It does not know whether the person was sedated, whether the pupils were assessed correctly, or whether the injury was traumatic; the severity bands apply to head injury, not to every cause of reduced consciousness. Never use it to decide what to do for a person who may be injured. Call emergency services.
Sources: Teasdale G, Jennett B, “Assessment of coma and impaired consciousness. A practical scale,” Lancet 1974;2:81–84; Teasdale G et al., “The Glasgow Coma Scale at 40 years: standing the test of time,” Lancet Neurol 2014;13:844–854; Brennan PM, Murray GD, Teasdale GM, “Simplifying the use of prognostic information in traumatic brain injury. Part 1: The GCS-Pupils score,” J Neurosurg 2018;128:1612–1620; the Glasgow Coma Scale website, glasgowcomascale.org (descriptors); CDC, Report to Congress on Mild Traumatic Brain Injury in the United States (2003), for the severity bands. Related: blood pressure calculator, Apgar score, target heart rate calculator.
For general information only — not medical advice, and not a tool for patient care decisions. Talk with a doctor or call emergency services about anyone you are worried about. How we check our calculators.