For healthcare professionals
Glasgow Coma Scale (GCS) calculator
The Glasgow Coma Scale rates level of consciousness from three responses: eye opening (1 to 4), verbal response (1 to 5) and motor response (1 to 6). The total runs from 3 to 15. Teasdale and Jennett introduced it in 1974, and it is used for head injury and any other cause of altered consciousness. This calculator is written for clinicians and is not a diagnosis.
Best response in each part
Record the best response seen. Choose "Not testable" when a part cannot be assessed (for example, intubation for verbal). Nothing you enter leaves this page.
What you will see
The total from 3 to 15, the E V M breakdown, the head injury severity band and, if pupils were assessed, the GCS-Pupils score.
Educational only, not medical advice. Not a diagnosis. The scale describes responsiveness; it does not find the cause.
Source
Teasdale G and Jennett B, Lancet 1974, the original scale. Scores, labels and the severity bands are taken from Table 1 of an open-access (CC BY 4.0) review, Andraos C et al., Cureus 2025. The GCS-Pupils rule is from Brennan PM et al., J Neurosurg 2018, as described in that review. The tests check every component range, the bands and the pupil rule.
Validated in
Introduced at the University of Glasgow to assess neurological dysfunction in acute medical and trauma patients, and used for any condition that alters consciousness. Most outcome research is in traumatic brain injury; the GCS-Pupils score was validated with CRASH and IMPACT trial data (Andraos 2025). This page uses the adult scale.
Limits
Intubation, facial or throat injury, language barriers and aphasia affect the verbal score; spinal cord injury complicates the responses to pain; alcohol and drugs lower scores. The same total can describe very different patients, so report the three parts. Children are harder to score. The original 1974 motor scale had five steps, giving a maximum of 14, and some clinicians still use it.
Glasgow Coma Scale table
Score the best response in each part and add them. The total runs from 3 (no response) to 15 (fully responsive) (Andraos 2025).
| Score | Eye opening | Verbal response | Motor response |
|---|---|---|---|
| 6 | - | - | Obeys commands |
| 5 | - | Oriented | Localizes pain |
| 4 | Spontaneously | Confused | Withdraws from pain |
| 3 | To voice | Inappropriate words | Abnormal flexion |
| 2 | To pain | Incomprehensible sounds | Abnormal extension |
| 1 | No response | No response | No response |
Source: Table 1 of Andraos et al., 2025 (Andraos 2025), after Teasdale and Jennett, 1974 (Teasdale 1974).
Head injury severity bands
In head injury, a total of 13 to 15 is classed as mild, 9 to 12 as moderate and 3 to 8 as severe (Andraos 2025). A total of 8 or less is often called coma, but in a study of 2,455 adults with disorders of consciousness, no patient with a score of 7 or 8 was diagnosed with coma, and scores from 7 to 11 covered the widest mix of conditions. The authors advised looking at the subscale scores, not only the total, especially at 8 or less (Andraos 2025).
Report the parts, not only the total
The parts measure different things: eye opening reflects arousal through the brainstem, motor response the motor pathways, and verbal response language function (Andraos 2025). International surveys found that 35% of clinicians reported only the summary score, and that stimuli for unresponsive patients varied widely; the survey authors stressed reporting the full scale for each patient and keeping the sum for group comparisons (Andraos 2025). Writing the result as E V M (for example E3 V4 M5) keeps that detail.
GCS-Pupils
The scale does not include the pupils, which can signal a neurological emergency after head injury. The GCS-Pupils score subtracts one point for each pupil that does not react to light, so it runs from 1 to 15. It was proposed to improve outcome prediction in traumatic brain injury and was validated with CRASH and IMPACT trial data (Andraos 2025) (Brennan 2018).
Limits
Intoxication lowers scores: in one trauma registry study, 150 of 187 patients with a first score of 3 had a positive drug or alcohol screen, and their scores changed more over time (Andraos 2025). Intubation, injury to the mouth or throat, aphasia and language barriers make the verbal part hard to score, and a person with locked-in syndrome may be fully alert yet unable to obey commands (Andraos 2025). Children are harder to score because of development and understanding of commands (Andraos 2025).
Related tools
The Glasgow Coma Scale is also the central nervous system item of the SOFA score. Confusion is one item of the qSOFA score for suspected infection and of the CURB-65 score for pneumonia. For stroke deficits, see the NIH Stroke Scale calculator; for a transient ischemic attack, see the ABCD2 score. For other clinician scores on this site, see the HEART score calculator, the Wells score for PE and the Alvarado score calculator.
Sources
- Andraos C, Siddiqi I, Brazdzionis J, et al. Limitations of the Glasgow Coma Scale: Challenges and Considerations. Cureus. 2025;17(2):e78900. doi:10.7759/cureus.78900. PMID 40091938. Open access (CC BY 4.0). Table 1 (the Glasgow Coma Scale and the mild, moderate and severe head injury bands), Review and Future directions (GCS-Pupils). pmc.ncbi.nlm.nih.gov/articles/PMC11908630/
- Brennan PM, Murray GD, Teasdale GM. Simplifying the use of prognostic information in traumatic brain injury. Part 1: The GCS-Pupils score: an extended index of clinical severity. J Neurosurg. 2018;128(6):1612-1620. doi:10.3171/2017.12.JNS172780. GCS-Pupils score (as described in Andraos 2025). doi.org/10.3171/2017.12.JNS172780
- Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81-84. doi:10.1016/s0140-6736(74)91639-0. Original Glasgow Coma Scale paper (not open access; scale taken from the open-access review above). doi.org/10.1016/s0140-6736(74)91639-0
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