Aim of the GCS:

• This system allows the conscious level of patients to be assessed and recorded using a numerical score. It's advantage is that it is relatively 'universal', in that it enables different health-care professionals to assess the patient at different times in order to make serial comparisons of the patient's conscious level.
• A score <8 is generally considered to be the 'cut-off' at which the patient may well require support with their airway. This should always be considered in unconscious patients.
• Use the mnemonic 'Mental State Examination' or 'MSE' to remember the order:
  • Motor (out of 6) / Speech (out of 5) / Eye-opening (out of 4)
• Total score = out of 15 / Minimum score = 3/15

Motor

• 6/6 = Able to move to command
• 5/6 = Localises to pain
• 4/6 = Withdraws to pain
• 3/6 = Abnormal flexor response to pain (decorticate)
• 2/6 = Abnormal extensor response to pain (decerebrate)
• 1/6 = No reponse

Speech

• 5/5 = Orientated
• 4/5 = Confused sentences
• 3/5 = Incoherent words
• 2/5 = Noises
• 1/5 = No reponse

Eye-opening

• 4/4 = Spontaneously open
• 3/4 = Opens to command
• 2/4 = Opens to pain
• 1/4 = Closed