The Three Categories
Eye opening is scored from 1 to 4, verbal response from 1 to 5, and motor response from 1 to 6. The total ranges from 3 to 15. A score of 8 or less indicates severe impairment and often requires airway protection.
Scoring Details
Eye opening: spontaneous 4, to voice 3, to pain 2, none 1. Verbal: oriented 5, confused 4, inappropriate words 3, incomprehensible sounds 2, none 1. Motor: obeys commands 6, localizes pain 5, withdraws 4, flexion 3, extension 2, none 1.
Using It in Practice
Record each component separately, not just the total, since a change in one area can be important. Reassess regularly to detect deterioration. Remember to adapt the verbal scale for young children, and be careful in intoxicated or hypoglycemic patients where the score may not reflect brain injury alone.