Glascow Coma Scale (GCS)

Glasgow Coma Scale (GCS) is a useful tool to aid assessing altered mental status. In some conditions the scale may be used to determine treatments. GCS is based on three objective assessments including eye movement, verbal response, and motor response.

Eyes (1-4)

Verbal (1-5)

Motor (1-6)

No eye opening – 1

No verbal response – 1 

No motor response – 1

Open to painful stimuli – 2

Incomprehensible sounds – 2

Extension / Decerebrate posturing – 2

Open to voice – 3

Inappropriate words – 3

Flexing / Decorticate – 3

Spontaneous opening – 4

Confused – 4

Withdraws from painful stimuli – 4

Oriented – 5

Localizes to painful stimuli – 5 

Obeys commands – 6 


GCS Practice

Use the following scenarios to practice calculating GCS. Document your answers in the recording sheet below. For the final 4 signoffs use scenarios from class and verify your work with another student.

  1. 46-year-old male sole driver involved in a motorcycle v. tree. He is bleeding from his mouth and ears and is unresponsive to painful stimuli.
  2. 16-year-old female complaining of respiratory distress. She answers your questions and believes she is having an asthma attack. She lets you know that she ran out of her inhaler. She is sitting in a tripod position.
  3. 33-year-old transgender male who was found in his home on the bathroom floor. He opens his eyes when you speak loudly and responds with mumbling. His medical alert bracelet tells you that he is an insulin dependent diabetic. He pushes your hand away when you shake him by the shoulders.
  4. 67-year-old male with stroke-like symptoms. He has right sided facial droop and grip weakness. His eyes are open and tracking you, though he cannot speak.
Glasgow Coma Scale Skills Verification Table

GCS Practice

1 (written)

2 (written)

3 (written)

4 (written)

5 (scenario)

6 (scenario)

7 (scenario

8 (scenario) (instructor)




Total Score


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Oregon EMS Psychomotor Skills Lab Manual Copyright © 2023 by Chris Hamper, BS, NRP; Carmen Curtz, Paramedic, BS; Holly A. Edwins, Paramedic, B.S.; and Jamie Kennel, PhD, MAS, NRP is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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