# What is the GCS score?

Adds the eye, verbal, and motor parts of the Glasgow Coma Scale to a total of 3 to 15, shows the usual head injury severity band, and gives the GCS-Pupils score.

- Page: https://www.acalculator.org/health/gcs-calculator
- JSON spec: https://www.acalculator.org/health/gcs-calculator.json
- Version: d35fd96bfc6d

## Default answer

Example with the default inputs (Eye opening (E) 4: Opens spontaneously, Verbal response (V) 5: Oriented, Motor response (M) 6: Obeys commands, Pupils (for GCS-P) Both react to light): The GCS score is 15 (E4 V5 M6), in the Mild band; the GCS-Pupils score is 15.

## Inputs

| Key | Label | Description |
| --- | --- | --- |
| e | Eye opening (E) | The best eye response, 1 to 4, or not testable (for example, eyes swollen shut). |
| v | Verbal response (V) | The best verbal response, 1 to 5, or not testable (for example, a breathing tube). |
| m | Motor response (M) | The best motor response of either arm, 1 to 6, or not testable (for example, sedation). |
| p | Pupils (for GCS-P) | How many pupils do not react to light: none, one, or both. |

## Outputs

| Key | Label | Description |
| --- | --- | --- |
| gcs | GCS score | Eye + verbal + motor, 3 to 15. |
| severity | Head injury severity | Severe 3 to 8, moderate 9 to 12, mild 13 to 15. |
| parts | Parts | The score written as E, V, and M. |
| gcsP | GCS-Pupils score | The GCS score minus the number of pupils that do not react to light, 1 to 15. |

## Method

GCS = eye (1 to 4) + verbal (1 to 5) + motor (1 to 6). GCS-P = GCS − pupil reactivity score (0, 1, or 2 pupils that do not react).

## Assumptions

- Score the best response seen. A part that cannot be tested is reported as NT, and no total is given.
- The severity bands (severe 3 to 8, moderate 9 to 12, mild 13 to 15) are the usual head injury grades, not a diagnosis.

## Worked examples

1. e = 4, v = 5, m = 6, p = 0 gives gcs = 15, severity = Mild, parts = E4 V5 M6, gcsP = 15. Source: Teasdale and Jennett 1974 scale: 4 + 5 + 6 = 15.
2. e = 2, v = 2, m = 4, p = 0 gives gcs = 8, severity = Severe, parts = E2 V2 M4, gcsP = 8. Source: Teasdale 2014 scale.
3. e = 3, v = 4, m = 5, p = 1 gives gcs = 12, severity = Moderate, parts = E3 V4 M5, gcsP = 11. Source: Brennan 2018: GCS-P = GCS − pupil reactivity score.
4. e = 1, v = 1, m = 1, p = 2 gives gcs = 3, severity = Severe, parts = E1 V1 M1, gcsP = 1. Source: Brennan 2018: the lowest GCS-P is 3 − 2 = 1.
5. e = 3, v = 5, m = 5, p = 0 gives gcs = 13, severity = Mild.

## FAQ

### What is the Glasgow Coma Scale?

A way to describe how awake and responsive a person is, published by Teasdale and Jennett in 1974. It rates three things: eye opening (1 to 4), the best verbal response (1 to 5), and the best motor response (1 to 6). The total runs from 3 (no response) to 15 (fully awake).

### What do the GCS bands mean?

The Glasgow Coma Scale FAQ grades head injury as mild (13 to 15), moderate (9 to 12), or severe (under 8). The Brain Trauma Foundation guidelines define severe traumatic brain injury as a GCS of 3 to 8 after resuscitation, so this page counts 8 as severe. A band describes a group and is not a diagnosis.

### What if a part cannot be tested?

Mark it NT (not testable), for example a breathing tube for the verbal part or swollen eyes. Do not score it as 1. The scale’s authors advise reporting the parts, such as E2 VNT M5, and not a total; this page then gives no total.

### What is the GCS-P score?

The GCS-Pupils score (Brennan 2018) takes the GCS total and subtracts the number of pupils that do not react to light (0, 1, or 2). It runs from 1 to 15 and adds the pupil check to the coma score in one number.

### Why report E, V, and M as well as the total?

The same total can come from very different patients. A score of 8 written as E2 V2 M4 says more than the number alone, so the parts are shown with the total.

### Who can use the scale?

The University of Glasgow holds the copyright of the GCS, and Sir Graham Teasdale that of the GCS-P. The scale’s website allows their use in clinical care and research at no cost, with acknowledgement. This page uses the 2014 terms for the responses.

## Sources

- Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974;2(7872):81-84. https://doi.org/10.1016/S0140-6736(74)91639-0 (retrieved 2026-10-05)
- Teasdale G, Maas A, Lecky F, et al. The Glasgow Coma Scale at 40 years: standing the test of time. Lancet Neurol. 2014;13(8):844-854. https://doi.org/10.1016/S1474-4422(14)70120-6 (retrieved 2026-10-05)
- Brennan PM, Murray GD, Teasdale GM. Simplifying the use of prognostic information in traumatic brain injury. Part 1: The GCS-Pupils score. J Neurosurg. 2018;128(6):1612-1620. https://doi.org/10.3171/2017.12.JNS172780 (retrieved 2026-10-05)
- Glasgow Coma Scale: What is GCS, FAQ, What is GCS-P, and Permissions. https://www.glasgowcomascale.org/ (retrieved 2026-10-05)
- Brain Trauma Foundation. Guidelines for the Management of Severe Traumatic Brain Injury, 3rd edition (severe TBI: GCS 3 to 8 after resuscitation). https://braintrauma.org/coma/guidelines/severe-tbi-3rd-edition (retrieved 2026-10-05)