For clinical reference only — does not replace local trust guidelines or clinical judgement.
Vital Signs

Reduced GCS

Reduced GCS

Severity
GCS
  • Mild
    GCS 13–14
  • Moderate
    GCS 9–12
  • Airway at risk
    GCS ≤ 8
🚨 Life-Threatening — exclude first
If suspected, escalate now.
Hypoglycaemia
Opioid / sedative overdose
Intracranial haemorrhage / stroke
Status epilepticus / post-ictal
Sepsis / encephalopathy
Severe hyponatraemia / hypercalcaemia
⚗️

Metabolic Causes

Hypoglycaemia / hyperglycaemia (DKA / HHS)Hyponatraemia / hypernatraemiaUraemic / hepatic encephalopathyHypercalcaemia
🫁

Hypoxia / Hypercapnia Causes

Type 2 respiratory failureSevere hypoxia from any cause
💊

Drugs & toxins Causes

OpioidsBenzodiazepinesAlcohol intoxication / withdrawalAntipsychotics, tricyclicsRecreational drugs
🧠

Neurological Causes

Stroke (ischaemic or haemorrhagic)Subarachnoid haemorrhageSubdural / extraduralSeizure / post-ictalMeningitis / encephalitisRaised ICP / SOL
🦠

Infective / Systemic Causes

SepsisSevere systemic illness
🤕

Trauma Causes

Head injurySpinal injury