GLASGOW COMA SCALE Revised GCS (2014) Eye Opening (E) Verbal Response (V) Best Motor Response (M) Spontaneous 4 Oriented 5 Obeying commands 6 To Speech 3 Confused 4 Localizing 5 To pressure 2 Words 3 Normal flexion (withdrawal) 4 None 1 Sounds 2 Abnormal flexion 3 None 1 Extension 2 None 1 Pupils Unreactive to Light Pupil Reactivity Score Both Pupils 2 One Pupil 1 Neither Pupil 0 GCS specifically recommends avoiding sternal rubs as it causes bruising & responses can be difficult to interpret. They also do not recommend routine use of retromandibular pressure. Revised GCS (2014) changes are underlined & highlighted in the above table. Maximum score -15, minimum score- 3 Best predictor of outcome: Motor response Repoing of Non-testable Score Aspects: In cases of a non-testable aspect, the new GCS should only be noted in its components. Any element that cannot be tested should be marked as NT. for "not testable". For intubated patients or patients with tracheostomy, VNT is used. It is no longer recommend to assign 1 point to non-testable elements, therefore a combined score should not be used. E- Opening of eyes on verbal command - 3 M-Movement of all 4 limbs spontaneously - 6 V-Patient on mechanical ventilation - Non-testable-0 The GCS score is (E3VNTM6) 9 for this patient.