Glasgow Coma Scale App for Pediatrics
User Guide
How to Use the Glasgow Coma Scale Learning App
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Select Criteria
For each patient case, you will need to select the appropriate response in the following categories:
- Eye Opening Response - Choose from spontaneous, response to voice, pain, or none.
- Verbal Response - Select the level of verbal response, ranging from oriented to no response.
- Motor Response - Choose the patient’s motor response, from obeying commands to no response.
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Calculate GCS Score
After selecting the responses in all three categories, click the "Calculate GCS" button. The app will automatically calculate the total GCS score based on the selections.
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View Prognosis
Once the GCS score is calculated, the app will display the prognosis based on the score:
- 13-15: Mild brain injury, good prognosis.
- 9-12: Moderate brain injury, guarded prognosis.
- 8 or below: Severe brain injury, poor prognosis.
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Review Case Scenarios
Below the GCS form, you will find several case scenarios. Click on each case to expand and read the detailed scenario, GCS score, and prognosis. These examples are helpful for learning and understanding different types of head injuries in children.
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Use the Table for Quick Reference
A table is provided to summarize GCS scores and associated prognoses for quick reference during use.
Tips:
- Ensure you select the most accurate responses to get the correct GCS score.
- Review multiple case scenarios to understand how different injuries affect GCS scores.
- Use the app to practice calculating GCS scores and interpreting them effectively.
Total GCS Score: 0
Prognosis:
| GCS Score | Prognosis |
|---|---|
| 13-15 | Mild brain injury, good prognosis |
| 9-12 | Moderate brain injury, guarded prognosis |
| 8 or below | Severe brain injury, poor prognosis |
Case 1: Mild Head Injury - GCS Score: 15
Scenario:
A 10-year-old child fell off a bike, hitting their head on the ground. Upon examination, the child opens their eyes spontaneously, is fully oriented, and follows commands without difficulty.
GCS:
- Eye Opening Response: Spontaneous (4)
- Verbal Response: Oriented (5)
- Motor Response: Obeys commands (6)
Total GCS Score: 15
Interpretation:
This is a case of mild brain injury. The child has a perfect GCS score, indicating a fully functional neurological status. There is no immediate threat to life, and the prognosis is very good. The child should be observed for any late signs of concussion, but the outcome is expected to be favorable.
Case 2: Moderate Head Injury - GCS Score: 10
Scenario:
A 6-year-old child was involved in a minor car accident. On examination, the child opens their eyes only to verbal commands, responds with confused speech, and withdraws from pain.
GCS:
- Eye Opening Response: To verbal command (3)
- Verbal Response: Confused (4)
- Motor Response: Withdraws from pain (4)
Total GCS Score: 10
Interpretation:
This child has a moderate brain injury with a GCS score of 10. While the child is responsive, there is evidence of disorientation and a delayed motor response. The prognosis is guarded, meaning close monitoring and further treatment may be required to ensure there are no complications such as brain swelling. With proper care, most children in this category recover well, but there is a risk of long-term cognitive or motor deficits.
Case 3: Severe Head Injury - GCS Score: 6
Scenario:
A 3-year-old child was struck by a falling object. Upon arrival at the emergency room, the child opens their eyes only in response to painful stimuli, makes incomprehensible sounds, and shows abnormal flexion to pain.
GCS:
- Eye Opening Response: To pain (2)
- Verbal Response: Incomprehensible sounds (2)
- Motor Response: Flexion to pain (decorticate) (3)
Total GCS Score: 6
Interpretation:
This child has a severe brain injury with a GCS score of 6. The child’s neurological state is concerning, as they are unresponsive to verbal commands and only respond to pain. The prognosis is poor, and immediate medical intervention is required to prevent further deterioration. Children with GCS scores this low are at risk of long-term disability, and the chance of full recovery decreases significantly.
Case 4: Mild Head Injury with Delayed Recovery - GCS Score: 13
Scenario:
A 12-year-old child suffered a head injury while playing sports. On initial examination, the child opens their eyes to verbal command, responds with appropriate words but appears confused at times, and localizes pain.
GCS:
- Eye Opening Response: To verbal command (3)
- Verbal Response: Appropriate but confused (4)
- Motor Response: Localizes pain (5)
Total GCS Score: 13
Interpretation:
This child has a mild brain injury with a GCS score of 13. While the prognosis is generally good, the confusion suggests a more prolonged recovery than typical mild cases. Observation is necessary, as symptoms like confusion or memory problems could persist for several days. Most children with this GCS score recover fully, but monitoring for signs of deterioration is crucial to prevent complications.
Case 5: Severe Head Injury with Poor Prognosis - GCS Score: 3
Scenario:
A 2-year-old child was in a major car accident. Upon examination, the child shows no eye opening, makes no verbal response, and shows no motor response, even to painful stimuli.
GCS:
- Eye Opening Response: None (1)
- Verbal Response: None (1)
- Motor Response: None (1)
Total GCS Score: 3
Interpretation:
This child has a GCS score of 3, the lowest possible score, indicating a deep coma and a very poor prognosis. There is no neurological response to any stimuli. The risk of mortality is high, and even if the child survives, the chances of meaningful neurological recovery are very slim. Immediate intensive care is essential, but the outlook remains grim.
