Coma levels are commonly assessed by two different scales: the Glasgow Coma Scale and the Ranchos Los Amigos Scale. The Glasgow Coma Scale is a standardized system used to assess the degree of brain impairment and to identify the seriousness of injury in relation to outcome.

The Glasgow Coma Scale involves three determinants: eye opening, verbal responses and motor response or movement. These determinants are evaluated separately according to a numerical value that indicates the level of consciousness and the degree of dysfunction. Scores run from a high of 15 to a low of 3. Persons are considered to have experienced a “mild” brain injury when their score is 13 to 15. A score of 9 to 12 is considered to indicate a “moderate” brain injury and a score of 8 or less reflects a “severe” brain injury. It should be noted, however, that the terms “mild,” “moderate” and “severe” are used as relative terms to describe the severity of the brain injury and are not meant to trivialize the seriousness of any brain injury.

How Scores Are Assigned

Eye Opening

spontaneous 4
to speech 3
to pain 2
no response 1

Best Motor Response

to verbal command: obeys 6
to painful stimulus: localizes pain 5
flexion-withdrawal 4
flexion-abnormal 3
extension 2
no response 1

Best Verbal Response

oriented and converses 5
disoriented and converses 4
inappropriate words 3
incomprehensible sounds 2
no response 1

Eye score + Motor score + Verbal score = 3 to 15