====== Pediatric Glasgow Coma Scale ======


https://www.mdcalc.com/calc/3702/pediatric-glasgow-coma-scale-pgcs

To be used in [[children]] under 2 years
((Borgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster 
A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care 
Applied Research Network (PECARN). Performance of the Pediatric Glasgow Coma
Scale Score in the Evaluation of Children With Blunt Head Trauma. Acad Emerg Med.
2016 Aug;23(8):878-84. doi: 10.1111/acem.13014. Epub 2016 Aug 1. PubMed PMID:
27197686.
)).

Prehospital and [[trauma center]] GCS scores frequently disagree in children, particularly in TBI patients aged <3 y and those with moderate TBI. Centers should consider the inconsistency of the pediatric GCS when triaging TBI patients
((Drews JD, Shi J, Papandria D, Wheeler KK, Sribnick EA, Thakkar RK. Prehospital
Versus Trauma Center Glasgow Coma Scale in Pediatric Traumatic Brain Injury
Patients. J Surg Res. 2019 Apr 22;241:112-118. doi: 10.1016/j.jss.2019.03.038.
[Epub ahead of print] PubMed PMID: 31022676.
)).

When compared to the Pediatric Trauma score (PTS), and the Injury Severity Score (ISS), the GCS may be a better predictor of mortality in cases of childhood trauma
((Yousefzadeh-Chabok S, Kazemnejad-Leili E, Kouchakinejad-Eramsadati L,
Hosseinpour M, Ranjbar F, Malekpouri R, Mohtasham-Amiri Z. Comparing Pediatric
Trauma, Glasgow Coma Scale and Injury Severity scores for mortality prediction in
traumatic children. Ulus Travma Acil Cerrahi Derg. 2016 Jul;22(4):328-32. doi:
10.5505/tjtes.2015.83930. PubMed PMID: 27598603.
)).
----


The Paediatric [[Glasgow Coma Scale]] (BrE) (also known as Pediatric Glasgow Coma Score (AmE) or simply PGCS) is the equivalent of the [[Glasgow Coma Scale]] (GCS) used to assess the level of [[consciousness]] of [[child]] patients. As many of the assessments for an [[adult]] [[patient]] would not be appropriate for [[infant]]s, the Glascow Coma Scale was modified slightly to form the PGCS. As with the GCS, the PGCS comprises three [[test]]s: [[eye]], verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible PGCS (the sum) is 3 (deep coma or death) whilst the highest is 15 (fully awake and aware person). The pediatric GCS is commonly used in emergency medical services. 

Best eye response: (E)

4. Eyes opening spontaneously
    
3. Eye opening to speech
    
2. Eye opening to pain
    
1. No eye opening or response

Best verbal response: (V)

5. Smiles, oriented to sounds, follows objects, interacts.
    
4. Cries but consolable, inappropriate interactions.
    
3. Inconsistently inconsolable, moaning.
    
2. Inconsolable, agitated.
    
1. No verbal response.


Best motor responses: (M)

6. Infant moves spontaneously or purposefully
    
5. Infant withdraws from touch
    
4. Infant withdraws from pain
    
3. Abnormal flexion to pain for an infant (decorticate response)
    
2. Extension to pain (decerebrate response)
    
1. No motor response

Any combined score of less than eight represents a significant risk of mortality. 

===== References =====