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Critical Care

Glasgow Coma Scale

Standardised neurological assessment of consciousness — Eye, Verbal, Motor response.

When to use: Used to objectively assess level of consciousness in trauma, stroke, metabolic encephalopathy, or any impaired consciousness. A GCS ≤8 is the threshold for considering endotracheal intubation to protect the airway.
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Formula
GCS = Eye (1–4) + Verbal (1–5) + Motor (1–6) Minimum: 3 (deep coma/death). Maximum: 15 (normal).
Key Points for NEET PG
  • GCS ≤8 = severe TBI; standard threshold for intubation to protect the airway
  • Motor score is the most prognostically important component of GCS
  • Intubated patients: record verbal as "T" (e.g., E4VTM6); minimum possible is 3T
  • Decorticate posturing (M3): flexion — lesion above midbrain; Decerebrate (M2): extension — pontine lesion
  • AVPU scale (Alert/Voice/Pain/Unresponsive) is a quick GCS equivalent: V≈13, P≈8, U≈3
References
Assessment of coma and impaired consciousness: A practical scale · The Lancet (1974)
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