15. Verbal response
Best Verbal Response
Score Age >5 Years Age 2-5 Years Age 0-2 Years
5 Oriented and converses Appropriate words Cries appropriately
4 Disoriented and converses Inappropriate words Weak Cries
3 Inappropriate words; cries Screams
Inappropriate
crying/screaming
2 Incomprehensible sounds Grunts Grunts
1 No response No response No response
17. Pediatric Age
Best Motor Response
Score Age 1 Year or Older Age 0-1 Year
6 Obeys command
5 Localizes pain Localizes pain
4 Flexion withdrawal Flexion withdrawal
3 Flexion abnormal (decorticate)
Flexion abnormal
(decorticate)
2 Extension (de-cerebrate)
Extension
(decerebrate)
1 No response No response
19. M2 vs M3
M3
Abnormal Flexion
Slow
Stereotyped
Arm across chest
Forearm rotates
Thumb clenched
Leg extends
Adducted shoulder
M2
Extesion
elbow hyperextension
pronate with
adducted shoulder
20.
21. Factor Affecting GCS Assessment- NT
Eye opening Verbal Motor
Raccoon eye/ edema Hard of hearing / hearing loss Limb injury/ splinted limb.
Orbital injury Tracheostomy paralysis
B/L 3rd nerve injury Maxillofacial trauma
22. In Quadriparesis/ splinted leg.
• If patients eye opening and Verbal response are normal –
almost always motors response will be normal.
• If patient able to show - his/her tongue, verbalizing normally –
fully conscious.
23. Important points
• Eye opening response – pain stimulus should be given over nail
/ shoulder pinch – to avoid grimace causes closure of eyes.
• Decorticate patient(persistent vegetative) may reacting visually
to people around them spontaneously – subcortical reflex.