AVPU

AVPU scheme (abbreviation for alert, voice, pain, unresponsive ) is a scheme in emergency medicine used to classify a patient's awareness. AVPU is a simplification of the Glasgow Coma Scale , which classifies a patient's consciousness on the basis of the four factors awake, reacts to speech, reacts to pain stimuli and no reaction, i.e. unconscious. Analogous to the English abbreviation AVPU, the abbreviation WASB (awake, speech, pain stimulus, unconscious) is used in German.

Meaning of the abbreviation

The AVPU scheme knows four possible results (in contrast to the 13 possibilities of the Glasgow Coma Scale ). The user should work through the AVPU in the order described (starting with A, ending with U) in order to avoid unnecessary tests on conscious patients.

Alert (awake and responsive): The patient is awake, responsive and attentive. He opens his eyes spontaneously and reacts to speech. Orientation and possible confusion are not criteria.
Voice (reacts to speech): The patient reacts somehow to verbal speech. The reaction can be verbal, visual, or motoric. The reaction can be in the form of opening eyes, a murmur, or the lifting of a finger.
Pain (reacts to pain stimulus): The patient reacts to a set pain stimulus. The reaction can be verbal, visual, or motoric.
Unresponsive (no response, passed out): This classification occurs when the patient showed no reaction under AVP.

In the area of first aid, a classification under A is usually regarded as an indication for further examinations and treatment. In the ambulance service, an AVPU classification is often started initially, in order to carry out a GCS classification later if the AVPU classification was worse than A.

Limits

The AVPU scheme is not suitable for long-term neurological monitoring of a patient.

Comparison with other systems

Compared to the Glasgow Coma Scale (GCS), the AVPU scheme corresponds as follows:

Alert: 15 GCS
Voice Responsive: 12 GCS
Pain Responsive: 8 GCS
Unresponsive: 3 GCS

Individual evidence

↑ Emergency paramedic / rescue service textbook . Cornelsen Verlag, Berlin 2014, ISBN 978-3-06-451000-5 , pp. 318 .
^ Georg Thieme Verlag KG: Save! Poster. Retrieved September 28, 2017 .
↑ CA Kelly, A. Upex, DN Bateman: Comparison of consciousness level assessment in the poisoned patient using the alert / verbal / painful / unresponsive scale and the Glasgow Coma Scale. In: Annals of emergency medicine. Volume 44, Number 2, August 2004, pp. 108-113, doi : 10.1016 / S0196064404003105 , PMID 15278081 .

[1] Emergency paramedic / rescue service textbook . Cornelsen Verlag, Berlin 2014, ISBN 978-3-06-451000-5 , pp. 318 .

[2] Georg Thieme Verlag KG: Save! Poster. Retrieved September 28, 2017 .

[3] CA Kelly, A. Upex, DN Bateman: Comparison of consciousness level assessment in the poisoned patient using the alert / verbal / painful / unresponsive scale and the Glasgow Coma Scale. In: Annals of emergency medicine. Volume 44, Number 2, August 2004, pp. 108-113, doi : 10.1016 / S0196064404003105 , PMID 15278081 .