How to Assess Level of Consciousness During First Aid

Assess Level of Consciousness During First Aid
Assess Level of Consciousness During First Aid

How to Assess Level of Consciousness During First Aid. Changes in the level of consciousness, or LOC, of a person who may have sustained an injury to the head are an important indicator of the way the brain is functioning. The scale used to measure this is commonly called "AVPU" for "alert," "verbal," responsive to "pain," or "unresponsive."

Things You'll Need

  • Pens
  • White Paper
  • White paper

Alert and Oriented?

Speak or yell to the injured person loudly and repeatedly, and note whether he or she responds verbally.

Ask the injured person his or her name.

Ask the injured person where he or she is.

Ask the injured person what day and time it is.

Ask the injured person what happened.

Write down the time and the number of these questions the injured person is able to answer. If the person answers at least one of the questions, he or she is an "A" on the AVPU scale.

Responsive to Verbal Stimuli?

Speak or yell to the injured person and see if he or she opens his or her eyes, moves, mumbles, or groans. If the injured person responds, he or she is a "V" on the AVPU scale.

Write down the time and a "V" for level of consciousness.

Responsive to Painful Stimuli?

Rub the injured person's breastbone with your knuckles and watch his or her face for movement.

Note the level of responsiveness. If he or she shows any movement or makes any sounds, he or she is a "P" on the AVPU scale.

Tips & Warnings

  • "Alert and oriented" is often referred to as "A and O" by medical professionals. It can be transcribed this way in your notes and passed on when you transfer care. The number of questions a person can answer indicates how oriented they are. If a person can answer three of the four questions, this is noted in the following manner: "LOC is A and O times 3."
  • Frequently ask the injured person the above four questions to note changes. If the person ceases to be able to answer any of the questions, move on to the following steps to assess responsiveness to verbal or painful stimuli.
  • Frequently reassess changes in the injured person's responsiveness to verbal stimuli and note these. If the injured person ceases to respond to verbal stimuli, go on to the following step to assess responsiveness to pain.
  • You may also pinch the injured person to measure responsiveness to pain.
  • If the injured person is not responsive to pain, he or she is considered unconscious. This is indicated as "U," or "unresponsive," on the AVPU scale.
  • Many deaths in the wilderness are due to brain injuries. Any person who receives a blow to the head should be seen by a medical professional immediately.
  • Changes in an injured person's level of consciousness should be reassessed frequently over a period of several hours.
  • Injuries to the brain may take several hours before they begin to affect the level of consciousness.
  • If symptoms persist, or if you have specific medical conditions or concerns, we recommend you contact a physician. This information is not intended as a substitute for professional medical advice or treatment.

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