Glasgow Coma Scale - Do it this way

Sep 20, 2026

Glasgow Coma Scale assessment instructions for eye opening, verbal response, and best motor response in patients with impaired consciousness. The guide specifies how to observe responses to different stimulus types, assigns ratings based on the highest observed response, and lists scoring criteria for spontaneous, sound-evoked, and finger-tip/pressure-evoked eye opening. It also provides verbal and motor response scoring ranges, plus options for physical stimulation sites and flexion response features.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Eye opening

Verbal response

Best motor response

Sites for physical stimulation

Flexion response features

GLASGOW COMA SCALE : Do it this way Institute of Neurological Sciences NHS Greater Glasgow and Clyde CH EC K For factors Interfering with communication, ability to respond and other injuries OBSE RV E STIMULAT E Eye opening , content of speech and movements of right and left sides Sound: spoken or shouted request Physical: Pressure on nger tip, trapezius or supraorbital notch RAT E Assign according to highest response observed Eye opening | Criterion | Observed | Rating | Score | | --- | --- | --- | --- | | Open before stimulus | | Spontaneous | 4 | | After spoken or shouted request | | To sound | 3 | | After ﬁnger tip stimulus | | To pressure | 2 | | No opening at any time, no interfering factor | | None | 1 | | Closed by local factor | | Non testable | NT | Verbal response | Criterion | Observed | Rating | Score | | --- | --- | --- | --- | | Correctly gives name, place and date | | Orientated | 5 | | Not orientated but communication coherently | | Confused | 4 | | Intelligible single words | | Words | 3 | | Only moans / groans | | Sounds | 2 | | No audible response, no interfering factor | | None | 1 | | Factor interferring with communication | | Non testable | NT | Best motor response | Criterion | Observed | Rating | Score | | --- | --- | --- | --- | | Obey 2-part request | | Obeys commands | 6 | | Brings hand above clavicle to stimulus on head neck | | Localising | 5 | | Bends arm at elbow rapidly but features not predominantly abnormal | | Normal 􀀝exion | 4 | | Bends arm at elbow, features clearly predominantly abnormal | | Abnormal 􀀝exion | 3 | | Extends arm at elbow | | Extension | 2 | | No movement in arms / legs, no interfering factor | | None | 1 | | Paralysed or other limiting factor | | Non testable | NT | Sites For Physical Stimulation Finger tip pressure Trapezius Pinch Supraorbital notch Features of Flexion Responses Modi􀀞ed with permission from Van Der Naalt 2004 Ned Tijdschr Geneeskd | Abnormal Flexion
Slow Sterotyped Arm across chest Forearm rotates Thumb clenched Leg extends | Normal ﬂexion
Rapid Variable
Arm away from body | | --- | --- | For further information and video demonstration [visit www.glasgowcomascale.org](visit www.glasgowcomascale.org) Graphic design by Margaret Frej based on layout and illustrations from Medical Illustration M I • 268093 (c) Sir Graham Teasdale 2015

FAQs

How should eye opening be assessed and scored?

Observe eye opening in response to stimulation and assign the rating based on the highest response observed. Use spontaneous opening for the top score, then sound-evoked, then finger-tip/pressure stimulation, with “none” if there is no opening.

What verbal response criteria are used in the Glasgow Coma Scale?

Evaluate speech response by checking orientation to name, place, and date; coherent but confused communication; intelligible single words; only sounds such as moans or groans; or none. Choose the score that matches the observed level, including “non testable” when a communication-interfering factor is present.

How is the best motor response determined?

Assess motor behavior using command obedience and specific movement patterns in response to stimulation. Rate the highest observed category, from obeying a two-part request down to no movement or a non-testable situation due to paralysis or other limiting factors.

Sep 20, 2026

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