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Pediatric Glasgow Coma Scale

The pediatric Glasgow Coma Scale (3–15) adapts verbal and motor responses for preverbal children: eye opening 1–4, verbal 1–5, motor 1–6. Severity: 13–15 mild, 9–12 moderate, ≤8 severe (consider airway protection).

  • Eye opening: Spontaneous (4); To speech / sound (3); To pain (2); None (1)
  • Verbal (preverbal infant / verbal child): Coos, babbles, smiles, follows objects / oriented (5); Irritable cry but consolable / confused (4); Cries to pain, inconsistently consolable, moaning / inappropriate words (3); Moans to pain, inconsolable, agitated / incomprehensible sounds (2); None (1)
  • Motor: Moves spontaneously and purposefully / obeys commands (6); Withdraws to touch / localises pain (5); Withdraws to pain (4); Abnormal flexion (decorticate) (3); Extension (decerebrate) (2); None (1)
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Interpretation

ResultMeaning
13–15Mild
9–12Moderate
≤ 8Severe; consider intubation

Formula

GCS = Eye (1–4) + Verbal (1–5) + Motor (1–6); preverbal descriptors for children ≤ 2 years

Clinical pearls

  • Use the preverbal verbal and motor descriptors for infants and children ≤ 2 years; standard GCS for verbal children.
  • Report the components (E, V, M), not just the total; motor score is the most predictive.
  • In the PECARN head-injury rules, GCS < 15 is a high-risk criterion for CT.

Examples

pediatric gcs eyes to pain, moans to pain, withdraws to paininfant gcs e4 v5 m6pgcs eyes open to voice, irritable but consolable, withdraws to touch

FAQ

How is GCS different in infants?

Eye opening is the same; the verbal score uses cooing, crying and consolability, and the top motor score is normal spontaneous movement instead of obeying commands.

What pediatric GCS needs intubation?

A GCS of 8 or less generally indicates severe brain injury and the need to secure the airway.

Evidence

  1. Holmes JF et al. Performance of the pediatric Glasgow Coma Scale in children with blunt head trauma. Acad Emerg Med 2005;12:814–9.

Pediatrics & Obstetrics · Reviewed 2026-10-14 · Methodology