EMS is taught to assess levels of consciousness through the Glasgow Coma Scale (GCS) and AVPU (alert/responsive to verbal stimuli/responsive to painful stimuli/unresponsive).
This study aimed to find a cut off point for where GCS and AVPU scales correlate. The National EMS Information System data set was used to look at over 4 million patient encounters that had both GCS and AVPU documented.
Lower AVPU scores correlated with life-sustaining procedures, including those for airway management, seizure, and cardiac arrest. Optimal GCS cut points obtained via a grid-based search were 14 to 15 for alert (A), 11 to 13 for verbal (V), 7 to 10 for pain (P), and 3 to 6 for unresponsive (U).
References
Ramgopal S, Horvat CM, Cash RE, Pelletier JH, Martin-Gill C, Macy ML. Comparing AVPU and Glasgow Coma Scales Among Children Seen by Emergency Medical Services. Pediatrics. 2024;154(2):e2024066168. doi:10.1542/peds.2024-066168
