Pediatric Glasgow Coma Scale (pGCS)
Assesses impaired consciousness and coma in pediatric patients.
Use for children 2 years and younger only. For older children, use the standard Glasgow Coma Scale (GCS). Note the difference between the Glasgow Coma Score (total score, only applicable when all three components are testable) and the Glasgow Coma Scale (component scores, applicable if any of three components is not testable).
Advice
- The score can be used to assess and track a patient’s mental status and level of consciousness. However, like the standard GCS, the score alone is not sufficient to guide diagnosis or management. (Teasdale 2014)
Management
- Although a valuable diagnostic tool, the score alone should not be used for management decisions in the acute setting.
- Common applications include the need to consider intubation/definitive airway management in those with a GCS less than 8. However, the entire clinical picture must be taken into account.
- Due in part to the value in identifying those with ciTBIs, any patient with an abnormal GCS warrants close assessment and monitoring.
Critical Actions
- All patients with a GCS <15 need appropriate monitoring.
- All patients with concern for mental status or neurologic compromise should be closely monitored and reassessed.