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    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
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    Patent Pending

    Pediatric Glasgow Coma Scale (pGCS)

    Assesses impaired consciousness and coma in pediatric patients.

    INSTRUCTIONS

    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).

    When to Use
    Pearls/Pitfalls
    Why Use
    • Infants with head trauma, altered mental status or neurologic abnormalities.
    • Use in initial and serial assessments.
    • The Pediatric Glasgow Coma Scale (pGCS) allows providers to obtain, track and communicate the mental status and level of consciousness in preverbal children (≤2 years of age).
    • Variation of the standard Glasgow Coma Scale (GCS) with age appropriate modifications to the motor and verbal components.
    • Scored 3-15 (eye, verbal and motor response) like the standard GCS
    • Should be reported as a sum and include the scores of each of the individual components because of the difference in prognostic value and variations of individual components versus the summed score. Example: Total pCGS 12=E3+V4+M5. (Healey C 2003)
    • As accurate for identifying clinically important traumatic brain injury (ciTBI) as GCS in verbal children.

    Points to keep in mind:

    • Best to obtain pGCS prior to the administration of analgesics or other interventions that could alter the score.
    • Somewhat less accurate in identifying those with ANY traumatic brain injury (TBI) on CT compared to the GCS in older children. (Borgialli DA 2016)
    • In intubated patients (for whom the verbal score may not be obtained), consider using the Full Outline of UnResponsiveness (FOUR score). This is a validated, expanded scoring system. (Wijdicks EF 2005) (Sadaka F 2012)
    • Distinction between normal and abnormal flexion may be challenging, especially for the non-specialist. (Reilly 1991)
    ≤2 years
    >2 years

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    Next Steps
    Evidence
    Creator Insights
    Dr. Graham Teasdale

    About the Creator

    Sir Graham Teasdale, MBBS, is an honorary professor at the Institute of Health and Wellbeing, University of Glasgow. He was previously the professor of neurosurgery, head of the department of neurosurgery, and associate dean for medical research at the University of Glasgow. Sir Teasdale was also the president of the Royal College of Physicians and Surgeons of Glasgow (2003-2006), and was knighted in 2006 for his services to neurosurgery.

    To view Dr. Graham Teasdale's publications, visit PubMed

    Content Contributors
    • Joyce Brown, MD
    Reviewed By
    • Matthew Meigh, DO
    About the Creator
    Dr. Graham Teasdale
    Partner Content
    Content Contributors
    • Joyce Brown, MD
    Reviewed By
    • Matthew Meigh, DO