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Simplified Motor Score (SMS)

Abbreviated Glasgow Coma Scale motor component for rapid triage of head trauma.

Simplified Motor Score (SMS)
Best motor response
Result2 points

Predicts GCS >=14 in most patients.

SMS (range 0-2)
2

When to use

  • Rapid prehospital or emergency department triage of possible traumatic brain injury when the full GCS is impractical.
  • Identifying patients who may need airway management or urgent neuroimaging using only the motor response.

Formula

Obeys commands = 2, localizes to pain = 1, withdraws to pain or worse = 0. Range 0-2.

Pearls and pitfalls

  • An SMS of 0-1 performs similarly to GCS <=8 for predicting need for neurosurgical intervention, endotracheal intubation, and mortality after trauma.

References

  1. Thompson DO, Hurtado TR, Liao MM, Byyny RL, Gravitz C, Haukoos JS. Validation of the Simplified Motor Score in the out-of-hospital setting for the prediction of outcomes after traumatic brain injury. Ann Emerg Med. 2011;58(5):417-425.