Archives of disease in childhood
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James' adaptation of the Glasgow coma scale (JGCS) was designed for young children. Intubated patients are not allocated a verbal score, however, so important changes in a patient's conscious level may be missed. A grimace score was therefore developed and assessed for use in intubated children. ⋯ Seventy three children had 104 sets of observations. Interobserver reliability was moderate to good for all components, with the grimace score better than the verbal score. It is concluded that the grimace score is more reliable than the verbal score and may be useful in intubated patients in whom the verbal score cannot be used.