When comparing the two ways of categorizing--the
AVPU categories and those of Ropper--there is a similarity between all categories except for "stupor," which can correspond to both V and R This might have led to the fictitious patient cases in category of P having slightly lower levels of consciousness compared with studies using patient cases categorized according to Ropper.
WHAT YOU SHOULD DO IF SOMEONE HAS IMPAIRED CONSCIOUSNESS Perform a quick check of consciousness using the
AVPU code.
A rapid method of assessing the patient's conscious level is '
AVPU':
Once Airway, Breathing, and Circulation are assessed, the neurologic status, or Disability, should be assessed beginning with level of consciousness using either the Glasgow coma scale or
AVPU (Alert, responds to Verbal stimuli, responds to Painful stimuli, Unresponsive) methods (Thomas & Bernardo, 2003).
RTR personnel abstracted data from the medical record to determine the AVPU score, which represented a measure of neurologic status on presentation to the initial hospital.
Variables that are significantly associated with increased mortality (i.e., positive coefficients) include: age > 55 years, log (ISS), head AIS of 5 (the most severe head injury), hypotension in the emergency department, and initial neurologic status other than alert (AVPU score of V, P, or U).
On a patient's arrival, according to the generic flowchart for the SATS, (12) nursing staff took a brief history and documented the main complaint, recorded vital signs, assessed mobility and level of consciousness according to the
AVPU scale (A = alert, V = responds to voice, P = responds to pain, U = unresponsive), and calculated a TEWS.
Use this
AVPU scale when it comes to checking their level of consciousness: