A guide to AVPU for first aiders

Being able to assess a patient’s level of consciousness is an important skill for any first aider. A wide range of injuries and medical conditions can affect the consciousness levels and first aiders should be able to recognise deterioration or improvement in patients. AVPU

There are various scales used to record a patient’s level of consciousness. One of the most detailed is the Glasgow Coma Scale which is used worldwide. The GCS is a reasonably complicated system, which unless you use regularly can be difficult to remember and apply correctly.

AVPU is a simplified version of the Glasgow Coma Scale which is easy to remember and apply to patients. It consists of four possible stages. When recording AVPU it is important to document the time the observation was taken and to track any changes over time as this will help medical staff.


Hopefully if you are reading this you fall into the ‘Alert’ category! Alert patients are fully awake (eyes spontaneously open, can follow commands etc.) although they can be confused


The stage down from Alert is Voice. This means the patient responds to a verbal stimulus. For example they might open their eyes or move around.


Next we have Pain. This category means the patient only responds upon application of a pain stimulus. There are various different methods to apply a pain stimulus, it is best to check with local policy/practice or your loca training provider as to the stimulus they recommend. It may only be appropriate to apply a peripheral pain stimulus such as squeezing the fingers or pinching the back of the hand.


Finally, if your patient does not respond to voice or pain then they are unresponsive.

John Furst

JOHN FURST is an experienced emergency medical technician and qualified first aid and CPR instructor. John is passionate about first aid and believes everyone should have the skills and confidence to take action in an emergency situation.

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