Pediatric GCS

Child-specific version of GCS to evaluate consciousness

Pediatric GCS

Child-specific version of GCS to evaluate consciousness

Eye opening (E)
Best eye response observed
Verbal response (V) — Child (>2y)
Use age-appropriate speech
Motor response (M) — Child (>2y)
PGCS — E0 V0 M0 (Child)
Choose one option in each card

Instructions

Use the Pediatric GCS for infants and children who may lack verbal skills or coordinated responses. Adjust the verbal and motor criteria based on developmental stage, observing spontaneous behaviors first. For children too young to follow commands, rely on age-appropriate responses, such as crying, cooing, or withdrawal to pain. Document the most appropriate and highest observed behavior in each domain, and note any unable-to-assess components due to developmental or medical limitations. Total scores still range from 3 to 15. Use the standard GCS for older children.

Overview
When to use
Why use
Evidences

Interpretation:

  • Score ≥13: Indicates a mild head injury

  • Score 9–12: Suggests a moderate head injury

  • Score ≤8: Reflects a severe head injury, often associated with a decreased level of consciousness

 The Pediatric GCS modifies the original scale for use in infants and young children, accounting for developmentally appropriate behaviors. Since its initial description, several pediatric versions have been validated, such as those used by the Pediatric Emergency Care Applied Research Network.

https://onlinelibrary.wiley.com/doi/10.1111/acem.13014

 Research indicates that consistency in the application of Pediatric GCS can be variable among less experienced healthcare providers, especially in the verbal component. Well-structured educational programs can greatly improve reliability and accuracy, ensuring optimal use in clinical practice.

http://pmc.ncbi.nlm.nih.gov/articles/PMC10896613/

 The CDC and NIH provide guidelines and resources on using Pediatric GCS as part of standard head trauma assessment. The tool is also referenced by the Brain Injury Association of America for evaluating pediatric brain injuries.

https://www.ncbi.nlm.nih.gov/books/NBK513298/

Overview
When to use
Why use
Evidences

The Pediatric Glasgow Coma Scale allows clinicians to assess consciousness levels in infants and children who cannot respond like adults. Developed as a child-specific alternative to the standard GCS, it uses adjusted criteria that reflect expected neurological and behavioral responses for age.

PGCS is especially critical in pediatric trauma, where developmental differences affect how children exhibit neurological signs. For example, a smiling or cooing baby may be equivalent to an alert verbal response in adults. Similarly, limb withdrawal to pain may replace following commands in preverbal toddlers.

Overview
When to use
Why use
Evidences

Interpretation:

  • Score ≥13: Indicates a mild head injury

  • Score 9–12: Suggests a moderate head injury

  • Score ≤8: Reflects a severe head injury, often associated with a decreased level of consciousness

 The Pediatric GCS modifies the original scale for use in infants and young children, accounting for developmentally appropriate behaviors. Since its initial description, several pediatric versions have been validated, such as those used by the Pediatric Emergency Care Applied Research Network.

https://onlinelibrary.wiley.com/doi/10.1111/acem.13014

 Research indicates that consistency in the application of Pediatric GCS can be variable among less experienced healthcare providers, especially in the verbal component. Well-structured educational programs can greatly improve reliability and accuracy, ensuring optimal use in clinical practice.

http://pmc.ncbi.nlm.nih.gov/articles/PMC10896613/

 The CDC and NIH provide guidelines and resources on using Pediatric GCS as part of standard head trauma assessment. The tool is also referenced by the Brain Injury Association of America for evaluating pediatric brain injuries.

https://www.ncbi.nlm.nih.gov/books/NBK513298/

Frequently Asked Questions

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What is the Pediatric GCS used for?+
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