GCS Child`s.pdf

Child’s Glasgow Coma Scale

Revised BPNA 2001

Pain should be made by pressing hard on the supra-orbital notch (beneath medial end of

eyebrow) with your thumb, except for M4, which is tested by pressing hard on the flat nail

surface with the barrel of a pencil.

Score the best response with unclear or asymmetrical. If in doubt repeat after 5 minutes and

ask for help.

Score as usual in the presence of sedative drugs. Plot over time on an appropriate chart e.g.

Child’s Neurological Assessment Chart.

>5 years

<5 years

Eye opening

Spontaneous

To voice

To pain

None

Eyes closed ( by swelling or bandage )

Verbal

V5 Orientated

Alert, babbles, coos, words or

( in person or place or address )

sentences to usual ability ( normal )

V4 Confused

Less than usual ability, irritable cry

V3 Inappropriate words

Cries to pain

V2 Incomprehensible sounds

Moans to pain

No response to pain

Intubated

Motor

M6 Obeys commands Normal spontaneous movements

M5 Localises to supraorbital pain (>9 months of age ) or withdraws to touch

Withdraws from nailbed pain

Flexion to supraorbital pain ( decorticate )

Extension to supraorbital pain ( decerebrate )

No response to supraorbital pain ( flaccid )

Acknowledgments: The Child’s Glasgow Coma Scale has evolved from adaptations to Jennett and Teasdale’s Glasgow Coma Scale

(1), by James and Trauner (2), Eyre and Sharples and by Tatman, Warren and Whitehouse (3), and paediatric nurse colleagues, Kirkham and

the British Paediatric Neurology Association GCS Audit Group. The Chart design is after Warren and Noons in association with the National

Paediatric Neuroscience Benchmarking Group.

References: 1: Jennett & Teasdale. Lancet 1977; i :878-881. 2: James & Trauner. Brain insults in infants and children . Orlando: Grune &

Stratton, 1985:179-182. 3: Tatman, Warren, Williams, Powell, Whitehouse. Archives of Disease in Childhood 1997; 77 :519-521.

Next revision : 2003

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