title: Paediatric Glasgow Coma Scale
text: # Paediatric Glasgow Coma Scale
  
  The Paediatric Glasgow Coma Scale (British English) or the Pediatric Glasgow Coma Score (American English) or simply PGCS is the equivalent of the Glasgow Coma Scale (GCS) used to assess the level of consciousness of child patients. As many of the assessments for an adult patient would not be appropriate for infants, the Glasgow Coma Scale was modified slightly to form the PGCS. As with the GCS, the PGCS comprises three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible PGCS (the sum) is 3 (deep coma or death) whilst the highest is 15 (fully awake and aware person). The pediatric GCS is commonly used in emergency medical services.
  
  In patients who are intubated, unconscious, or preverbal, the motor response is considered the most important component of the scale.
  
  ## Coma scale
  
  Pediatric Glasgow Coma Scale :
  
  | | 1 | 2 | 3 | 4 | 5 | 6 |
  | - | - | - | - | - | - | - |
  | Eyes | Does not open eyes | Opens eyes in response to painful stimuli | Opens eyes in response to speech | Opens eyes spontaneously | N/A | N/A |
  | Verbal | No verbal response | Inconsolable, agitated | Inconsistently inconsolable, moaning | Cries but consolable, inappropriate interactions | Smiles, orients to sounds, follows objects, interacts | N/A |
  | Motor | No motor response | Extension to pain (decerebrate response) | Abnormal flexion to pain for an infant (decorticate response) | Infant withdraws from pain | Infant withdraws from touch | Infant moves spontaneously or purposefully |
  
  Any combined score of less than eight represents a significant risk of mortality. A score of 12 or below indicates a severe head injury. A score of less than 8 indicates that intubation and ventilation may be necessary. A score of 6 or below indicates that intracranial pressure monitoring may be necessary.
  
  ## Modified Glasgow Coma Scale for Infants and Children
  
  Modified Glasgow Coma Scale for Infants and Children :
  
  | Area Assessed | Infants | Children | Score |
  | - | - | - | - |
  | Eye opening | No response | No response | 1 |
  | | Open in response to pain only | Open in response to pain only | 2 |
  | | Open in response to verbal stimuli | Open in response to verbal stimuli | 3 |
  | | Open spontaneously | Open spontaneously | 4 |
  | Verbal response | No response | No response | 1 |
  | | Moans in response to pain | Incomprehensible words or nonspecific sounds | 2 |
  | | Cries in response to pain | Inappropriate words | 3 |
  | | Irritable cries | Confused | 4 |
  | | Coos and babbles | Oriented, appropriate | 5 |
  | Motor response | No response | No response | 1 |
  | | Responds to pain with decerebrate posturing (abnormal extension) | Responds to pain with decerebrate posturing (abnormal extension) | 2 |
  | | Responds to pain with decorticate posturing (abnormal flexion) | Responds to pain with decorticate posturing (abnormal flexion) | 3 |
  | | Withdraws in response to pain | Withdraws in response to pain | 4 |
  | | Withdraws to touch | Localizes painful stimulus | 5 |
  | | Moves spontaneously and purposefully | Obeys commands | 6 |
  