Paediatric Glasgow Coma Scale
Age-modified GCS for children under 5 years, accounting for developmental verbal and motor responses.
How to use & interpret
The Paediatric Glasgow Coma Scale adapts the GCS for infants and young children who cannot follow standard verbal and motor commands, using age-appropriate descriptors for the verbal and motor responses while keeping the same 3–15 range and E/V/M structure.
As in adults, record the three components separately, track the trend, and treat a score ≤8 or a fall of ≥2 points as significant. Note confounders (post-ictal state, sedation, intubation) and escalate early.
Score interpretation
Paediatric GCS 3–8: Severe impairment. Coma. Airway at high risk.
→ IMMEDIATE airway management. RSI with paediatric doses. Call PICU/retrieval team. CT head if stable. Consider ICP management: head 30°, PaCO₂ 4.5–5.0 kPa, avoid hypotension.
Paediatric GCS 9–12: Moderate impairment. Close monitoring required.
→ Continuous monitoring. Frequent GCS reassessment. IV access. Consider CT head. Paediatrician / PICU review if not improving. Glucose check.
Paediatric GCS 13–15: Mild or no neurological impairment.
→ Observe. Investigate underlying cause. If GCS 13–14, still consider CT/investigation per clinical context. Serial GCS every 30 min.
Interpretation bands for the Paediatric GCS. Apply clinical judgement and local guidance.
Frequently asked questions
When should I use the paediatric rather than adult GCS?
Use the paediatric version for children who are pre-verbal or developmentally unable to give standard verbal/motor responses (broadly under ~5 years); older children can use the adult scale.
References
- Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974.
- NICE CG176. Head injury: assessment and early management. 2014.
Related
Curated clinical cross-links plus same-class fallbacks.
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Pembrolizumab (Head and Neck SCC) · PD-1 Inhibitor
- Nivolumab (Head and Neck SCC) · PD-1 Inhibitor
- Melatonin · Melatonin Receptor Agonist
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.