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Pediatric Glasgow Coma Scale (pGCS)

Score the best observed eye-opening response. Wording is the same for all ages.

Score the best age-appropriate response. Each level pairs the verbal-child descriptor with its infant/preverbal equivalent — apply the one matching the child's developmental band.

Score the best age-appropriate motor response. Each level pairs the verbal-child descriptor with its infant/preverbal equivalent.

Independent clinical validation: pending

Two independent clinical validators will be named here once review is complete.

Validator slot open 1
Validator slot open 2

How it is calculated

Total pGCS = E + V + M, the ordinal sum of the eye-opening (E, 1–4), verbal/vocal (V, 1–5), and motor (M, 1–6) components, each taken as the best observed age-appropriate response; the total therefore ranges 3–15 with no 0 (Teasdale & Jennett 1974). There are no physical units and components are never interpolated. The single total is stratified into the conventional TBI-severity tri-band: 3–8 ('severe'), 9–12 ('moderate'), and 13–15 ('mild').

Limitations and notes

Two lineages with different age cut-offs exist: James/PECARN (preverbal <2 y vs verbal ≥2 y, per Holmes 2005 / Borgialli 2016) and BPNA 'Child's GCS' (<5 y vs >5 y). A total is not comparable across schemes unless the scheme and age band are recorded — pin and store both per case. The E/V/M option labels here are neutral paraphrases spanning both the verbal-child and infant/preverbal descriptor columns; exact GCS wording is stewarded by the Royal College of Physicians and Surgeons of Glasgow / Teasdale (glasgowcomascale.org). Intubation breaks the plain sum: BPNA records the verbal component as a non-numeric 'T' (which is why the grimace score was introduced, Tatman 1997), while some US practice records V=1 with a 'T' suffix; this score computes a plain E+V+M and does not model 'T'. [NEEDS SOURCE] a single canonical rule for numerically substituting V=1 for intubated verbal in the James/PECARN branch (primary sources describe the code, not an arithmetic substitution). The 13–15/9–12/3–8 tri-band originated in adult TBI work; pediatric literature refines the 'severe' cut downward (≤5) for young children (StatPearls NBK513298). Sedation/paralysis makes V and M uninformative — flag such scores. Further [NEEDS SOURCE]: the original Reilly 1988 Adelaide per-level age-expected table and the James & Trauner 1985 chapter pagination were not independently verified from primary full text.

Accepted input ranges

  • Eye-opening response
  • Verbal / vocal response
  • Motor response

References

  1. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81–84.PMID 4136544DOI 10.1016/s0140-6736(74)91639-0
  2. Reilly PL, Simpson DA, Sprod R, Thomas L. Assessing the conscious level in infants and young children: a paediatric version of the Glasgow Coma Scale. Childs Nerv Syst. 1988;4(1):30–33.PMID 3135935DOI 10.1007/BF00274080
  3. James HE. Neurologic evaluation and support in the child with an acute brain insult. Pediatr Ann. 1986;15(1):16–22.PMID 3951884DOI 10.3928/0090-4481-19860101-05
  4. Tatman A, Warren A, Williams A, Powell JE, Whitehouse W. Development of a modified paediatric coma scale in intensive care clinical practice. Arch Dis Child. 1997;77(6):519–521.PMID 9496188DOI 10.1136/adc.77.6.519
  5. British Paediatric Neurology Association. Child's Glasgow Coma Scale (Revised BPNA 2001). Audit chart.Source
  6. Holmes JF, Palchak MJ, MacFarlane T, Kuppermann N. Performance of the pediatric Glasgow Coma Scale in children with blunt head trauma. Acad Emerg Med. 2005;12(9):814–819.PMID 16141014DOI 10.1197/j.aem.2005.04.019
  7. Borgialli DA, Mahajan P, Hoyle JD Jr, et al; PECARN. Performance of the Pediatric Glasgow Coma Scale Score in the Evaluation of Children With Blunt Head Trauma. Acad Emerg Med. 2016;23(8):878–884.PMID 27197686DOI 10.1111/acem.13014
  8. Jain S, Iverson LM. Glasgow Coma Scale. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Source

Version and changelog

v1.0.0 · General

  • 2026-07-25 v1.0.0 — Initial release: Pediatric GCS (E+V+M, 3–15) with paraphrased age-adapted option labels and conventional severity bands.

Important

For use by qualified health professionals as an informational and educational aid. It supports clinical judgment and does not replace it. Verify every result independently before making a clinical decision. This is not a medical device.