I am reading all this and am impressed with the depth of knowledge I am seeing in this thread, however I do have to make one comment. The GCS score seems to be important in a small category of pts such as those with a traumatic brain injury (TBI), but for most of the pt's GCS just doesn't seem that important. I would have to agree that a total GCS score of less than 8 is nesscary before anyone really is going to care at the recieving hospital, But that kind of a score requires severe motor impairment and that is the more important finding!! I also think that the GCS should be revised so as to be able to assign a zero score. Our PCR requires a GCS score and I am tired of explaining to a lawyer or manager why this person scored a three and had been dead for two days and a pt alive and seriously injured scored no better.