| Area Assessed | Infants | Children | Score* | |
| Eye opening | Open spontaneously | Open spontaneously | 4 | |
| Open in response to verbal stimuli | Open in response to verbal stimuli | 3 | ||
| Open in response to pain only | Open in response to pain only | 2 | ||
| No response | No response | 1 | ||
| Verbal response | Coos and babbles | Oriented, appropriate | 5 | |
| Irritable cries | Confused | 4 | ||
| Cries in response to pain | Inappropriate words | 3 | ||
| Moans in response to pain | Incomprehensible words or nonspecific sounds | 2 | ||
| No response | No response | 1 | ||
| Motor response** | Moves spontaneously and purposefully | Obeys commands | 6 | |
| Withdraws to touch | Localizes painful stimulus | 5 | ||
| Withdraws in response to pain | Withdraws in response to pain | 4 | ||
| Responds to pain with decorticate posturing (abnormal flexion) | Responds to pain with flexion | 3 | ||
| Responds to pain with decerebrate posturing (abnormal extension) | Responds to pain with extension | 2 | ||
| No response | No response | 1 |
*Score:
12 suggests a severe head injury.
8 suggests need for intubation and ventilation.
6 suggests need for intracranial pressure monitoring.
**If the patient is intubated, unconscious, or preverbal, the most important part of this scale is motor response. This section should be carefully evaluated.
Adapted from Davis RJ et al: Head and spinal cord injury. In Textbook of Pediatric Intensive Care, edited by MC Rogers. Baltimore, Williams & Wilkins, 1987; James H, Anas N, Perkin RM: Brain Insults in Infants and Children. New York, Grune & Stratton, 1985; and Morray JP et al: Coma scale for use in brain-injured children. Critical Care Medicine 12:1018, 1984.
Source : www.northeastcenter.com
