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GCS evaluates eye (E), verbal (V), and motor (M) responses. Eye opening to pain is E2 (4-spontaneous, 3-to voice, 2-to pain, 1-none). Incomprehensible sounds are V2 (5-oriented, 4-confused, 3-inappropriate words, 2-incomprehensible sounds, 1-none). Withdrawal from pain is M4 (6-follows commands, 5-localizes pain, 4-withdraws, 3-abnormal flexion/decorticate, 2-extension/decerebrate, 1-none). Summing E2 + V2 + M4 = 8. A GCS of 8 indicates severe impairment and risk for airway compromise (“GCS 8, intubate” is an ALS consideration; for EMTs, it underscores aggressive airway management and rapid transport). Frequent reassessment is important, as GCS can change with hypoxia, hypoglycemia, or intracranial injury. Combine GCS with the primary assessment (airway, breathing, circulation), pupil exam, and vital signs. Maintain airway patency, provide oxygen/ventilations as needed, control external bleeding, and prioritize rapid transport to a facility capable of managing potential traumatic brain injury.