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Paediatric Glasgow Coma Scale Chart Name: Date: CHI Number: Time: P U P I L S Size (1-8) + reacts - no reaction c eye closed Record right (r) and left (l) separately if there is a difference between the two sides. Eyes closed by swelling = C Endotracheal Tube or Tracheostomy = T Usually record best arrival response. Right Reaction Left Reaction Normal power Normal power Mild weakness Mild weakness Severe weakness Severe weakness Spontaneously Obeys commands Orientated Spastic flexion Spastic flexion To speech Localise pain Confused Extension Extension To pain Withdrawal to pain Inappropriate Words No response No response None Extension to pain TOTAL COMA SCORE None None Flexion to pain Incomprehensible Sounds Size (1-8) FEATURE SCALE RESPONSE SCORE Eye Opening Spontaneous 4 To voice 3 To pain 2 None 1 Verbal response Orientated/interacts/follows objects/smiles/alert/coos/babbles words to usual ability 5 Confused/consolable 4 Inappropriate words/moaning 3 Incomprehensible sounds/irritable/inconsolable 2 None 1 Best motor response Obeys commands/normal movement 6 Localise pain/withdraws to touch 5 Withdrawal to pain 4 Flexion to pain 3 Extension to pain 2 None 1 TOTAL COMA ‘SCORE’ 3/15 - 15/15 L I M B M O V E M E N T C O M A S C A L E A R M S L E G S EYES OPEN BEST VERBAL RESPONSE BEST MOTOR RESPONSE Pupil Scale (mm) 1 2 3 4 5 6 7 8 4 4 5 4 5 6 3 3 3 2 2 2 1 1 1 COMPLETE SCORES IN SHADED SECTION

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Page 1: penilaian GCS pada anak

Paediatric Glasgow Coma Scale ChartName:

Date:

CHI Number:

Time:

PUPILS

Size (1-8) + reacts

- no reaction

c eye closed

Record right (r)

and left (l)

separately if

there is a

difference

between the

two sides.

Eyes closed by

swelling = C

Endotracheal

Tube or

Tracheostomy

= T

Usually record

best arrival

response.

Right Reaction

Left Reaction

Normal power

Normal power

Mild weakness

Mild weakness

Severe weakness

Severe weakness

Spontaneously

Obeys commands

Orientated

Spastic flexion

Spastic flexion

To speech

Localise pain

Confused

Extension

Extension

To pain

Withdrawal to pain

Inappropriate Words

No response

No response

None

Extension to pain

TOTAL COMA SCORE

None

None

Flexion to pain

Incomprehensible Sounds

Size (1-8)

FEATURE SCALE RESPONSE SCORE

Eye Opening Spontaneous 4 To voice 3 To pain 2 None 1

Verbal response Orientated/interacts/follows objects/smiles/alert/coos/babbles words to usual ability 5 Confused/consolable 4 Inappropriate words/moaning 3 Incomprehensible sounds/irritable/inconsolable 2 None 1

Best motor response Obeys commands/normal movement 6 Localise pain/withdraws to touch 5 Withdrawal to pain 4 Flexion to pain 3 Extension to pain 2 None 1

TOTAL COMA ‘SCORE’ 3/15 - 15/15

LI

MB

MOVEMENT

C

O

M

A

S

C

A

L

E

ARMS

LEGS

EYES

OPE

NBE

ST V

ERBA

L RE

SPO

NSE

BEST

MO

TOR

RESP

ON

SE

PupilScale(mm)

1 2 3 4 5 6 7 8

4

4

5

4

5

6

3

3

3

2

2

2

1

1

1

COmPLETE SCORES iN ShAdEd SECTiON