Paediatric Glasgow Coma Scale

How to use it

1. 1

   Verbal scale modified for age. < 2 years: normal verbal = cooing/babbling/smiling. 2–5 years: crying consolably = grade 4.

2. 2

   Motor scale unchanged. Best limb response as with adult GCS.

3. 3

   GCS ≤ 8. Severe TBI threshold in children as in adults — consider intubation.

When to use it

Paediatric head injury

PECARN head CT decision rule uses GCS < 15 as one criterion.

Altered consciousness in child

Hypoglycaemia, meningitis, encephalitis, ingestion — serial pGCS tracks response.

PICU admission

Baseline pGCS documents neurological status for monitoring.