Pediatric GCS

Assess level of consciousness in children under 2 years where verbal responses differ from adults.

Indication

Assess level of consciousness in children under 2 years where verbal responses differ from adults.

id: eye; label: Eye opening; type: options; options: value: 4; label: Spontaneous; value: 3; label: To voice; value: 2; label: To pain; value: 1; label: None
id: verbal; label: Verbal response (modified for children); type: options; options: value: 5; label: Smiles, oriented to sounds, follows objects, interacts; value: 4; label: Crying but consolable, inappropriate interactions; value: 3; label: Inconsistently consolable, moaning; value: 2; label: Inconsolable, agitated; value: 1; label: No response
id: motor; label: Motor response; type: options; options: value: 6; label: Obeys commands; value: 5; label: Localizes pain; value: 4; label: Withdraws from pain; value: 3; label: Abnormal flexion; value: 2; label: Extension; value: 1; label: None

function(score) { if (score >= 13) return { risk: score + '/15', tier: 'Mild', action: 'Routine monitoring. Reassess for deterioration.', color: 'green' }; if (score >= 9) return { risk: score + '/15', tier: 'Moderate', action: 'Close monitoring; neurosurgery or PICU consultation.', color: 'yellow' }; return { risk: score + '/15', tier: 'Severe', action: 'Airway protection (GCS \u22648 = intubation threshold), PICU, neurosurgery.', color: 'red' }; }

The verbal component is the key modification — a normal score for an infant is a social smile and appropriate vocalization
A child crying but consolable scores higher than an inconsolably crying child
Intubation threshold of GCS ≤8 applies to children as well as adults

Reilly PL et al. Lancet 1988; Morray JP et al. Crit Care Med 1984. Last reviewed: 2025-01-01