How to score the Glasgow Coma Scale
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
The GCS describes consciousness in three parts. Record each part, not just the total.
Step by step
Check
Hearing, language, sedation, injuries that limit a response. [1]
Observe
See what the patient does without stimulation. [1]
Stimulate
Speak, then raise your voice, then apply pressure (fingertip, trapezius or above the eye). [1]
Eyes (1 to 4)
Spontaneous 4, to voice 3, to pressure 2, none 1. [1]
Verbal (1 to 5)
Oriented 5, confused 4, words 3, sounds 2, none 1. [1]
Motor (1 to 6)
Obeys 6, localizes 5, normal flexion 4, abnormal flexion 3, extension 2, none 1. [1]
Record
For example E3 V4 M6 = 13. A total of 8 or less often needs airway protection. [1]
Common errors
- Only the total.
- Rubbing the sternum hard.
- Not noting why a part cannot be tested.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Opioid overdose in the waiting room
- Altered mental status, unknown cause
- Hypoglycemia, unresponsive
- Airway management, unresponsive patient
- Head injury
- Fentanyl overdose in the field
11 Making Synapses cases train this skill: open the case library
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- NCCPA PANCE Content Blueprint
- Stanford Medicine 25 (bedside exam)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.