Pediatric Glasgow Coma Scale
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1Assessing trauma severity
A clear and concise communication between the pre-hospital system and the hospital center is
essential. This communication should be both simple and as detailed as possible in describing
the patient’s state. The Pediatric Glasgow Coma Scale (GCS) and the Pediatric Trauma Scale
(PTS) meet these criteria. Their use will improve quality of care services and reduce the delay
between the time of the evaluation, the investigation and the interventions. The Trauma Programs
of the Montreal Children’s Hospital endorses the use of the GCS and the PTS.
The Pediatric Glasgow Coma Scale
Although developed many years ago, the GCS remains an important scale. Its use has been
recommended by the MSSS in the 2005 Ministry report pertaining to trauma care.
The GCS can be used to monitor the child’s level of consciousness during both the pre-hospital
and hospital care. The score ranges from 3 to 15. A higher score represents a higher level of
consciousness. It is preferable to give the score on each measure of response, rather than just
giving the total score.
LEVEL OF CONSCIOUSNESS – PEDIATRIC GLASGOW COMA SCALE:
(GCS range: 3 to 15)
EYE OPENING
VERBAL RESPONSE
MOTOR RESPONSE
Age : > 2yrs
≤ 2 yrs
≤ 2 yrs
≤ 2 yrs
Age : >2 yrs
Age : > 2 yrs
Spontaneous 4 Spontaneous
Oriented 5 Coos, babbles
Obeys commands 6 Normal, spontaneous
To voice 3 To speech
Confused 4 Irritable, cries
Localizes pain 5 Withdraws to touch
To pain 2 To pain
Inappropriate 3 Cries to pain
Withdraws to pain 4 Withdraws to pain
None 1 None
Incomprehensible 2 Moans to pain
Flexion to pain 3 Abnormal flexion
None 1 None
Extension to pain 2 Abnormal extension
None 1 None
Eye opening = _____
Verbal = _____
Motor =____
TOTAL = ____________/ 15
The Pediatric Trauma Score
The PTS was developed to reflect the children’s vulnerability to traumatic injury. It emphasizes
the importance of the child’s weight and airway. Several studies have confirmed that the PTS is a
valid tool in predicting mortality of a traumatically injured child. Mortality is estimated at 9% with a
PTS > 8, and at 100% with a PTS ≤ 0. There is a linear relationship between the decrease in PTS
and the mortality risk (i.e. the lower the PTS, the higher the mortality risk). The minimal score is -6
and the maximum score is +12.
+2
+1
-1
Pediatric Trauma
Score (PTS)
Weight
> 20 kg (44 lbs.)
10-20 kg (22-44 lbs.)
< 10 kg (22 lbs.)
Airway
Patent
Maintainable
Unmaintainable
Systolic B/P
> 90 mm Hg
50-90 mm Hg
< 50 mm Hg
CNS
Awake
+ LOC
Unresponsive
Fractures
None
Closed or suspected
Multiple closed or open
Wounds
None
Minor
Major, penetrating or burns
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