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Modified Glasgow Coma Scale for Infants and Children

Modified Glasgow Coma Scale for Infants and Children

Area Assessed

Infants

Children

Score*

Eye opening

Open spontaneously

Open spontaneously

4

Open in response to verbal stimuli

Open in response to verbal stimuli

3

Open in response to pain only

Open in response to pain only

2

No response

No response

1

Verbal response

Coos and babbles

Oriented, appropriate

5

Irritable cries

Confused

4

Cries in response to pain

Inappropriate words

3

Moans in response to pain

Incomprehensible words or nonspecific sounds

2

No response

No response

1

Motor response†

Moves spontaneously and purposefully

Obeys commands

6

Withdraws to touch

Localizes painful stimulus

5

Withdraws in response to pain

Withdraws in response to pain

4

Responds to pain with decorticate posturing (abnormal flexion)

Responds to pain with decorticate posturing (abnormal flexion)

3

Responds to pain with decerebrate posturing (abnormal extension)

Responds to pain with decerebrate posturing (abnormal extension)

2

No response

No response

1

* Score ≤ 12 suggests a severe head injury. Score ≤ 8 suggests the possible need for intubation and ventilation as well as the need for intracranial pressure monitoring.

† If the patient is intubated, unconscious, or preverbal, the most important part of this scale is motor response. This section should be carefully evaluated.

Adapted from Davis RJ et al. Head and spinal cord injury. In Textbook of Pediatric Intensive Care, edited by MC Rogers. Baltimore, Williams & Wilkins, 1987; James H, Anas N, Perkin RM. Brain Insults in Infants and Children. New York, Grune & Stratton, 1985; and Morray JP, Tyler DC, Jones TK, et al. Coma scale for use in brain-injured children. Critical Care Medicine. 1984;12:1018–1020. doi: 10.1097/00003246-198412000-00002; and Carney N, Totten AM, O'Reilly C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery 2017;80(1):6-15. doi: 10.1227/NEU.0000000000001432.

* Score ≤ 12 suggests a severe head injury. Score ≤ 8 suggests the possible need for intubation and ventilation as well as the need for intracranial pressure monitoring.

† If the patient is intubated, unconscious, or preverbal, the most important part of this scale is motor response. This section should be carefully evaluated.

Adapted from Davis RJ et al. Head and spinal cord injury. In Textbook of Pediatric Intensive Care, edited by MC Rogers. Baltimore, Williams & Wilkins, 1987; James H, Anas N, Perkin RM. Brain Insults in Infants and Children. New York, Grune & Stratton, 1985; and Morray JP, Tyler DC, Jones TK, et al. Coma scale for use in brain-injured children. Critical Care Medicine. 1984;12:1018–1020. doi: 10.1097/00003246-198412000-00002; and Carney N, Totten AM, O'Reilly C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery 2017;80(1):6-15. doi: 10.1227/NEU.0000000000001432.

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