AVPU Scale
Use the AVPU Scale to designate an appropriate level of consciousness for a patient and record it when they are being treated or unconscious due to an injury or illness.
Fact Checked by Nate Lacson.
What is an AVPU Scale?
The Alert, Voice, Pain, Unresponsive Scale, or the for short (and pronounced as aveh pooh), is a tool used by healthcare professionals and first aid responders to describe the level of consciousness of a particular person. It is used by all healthcare providers, especially those who conduct operation procedures, administer treatment, and EMTs and paramedics transporting patients to a medical facility. It’s one of the most essential tools that healthcare professionals and providers should have.
The AVPU scale is divided into four parts:
- A = This stands for Alert. This means that the patient is awake. However, even if they are awake and alert, they will likely be dazed and confused, especially if on medicine that makes them groggy or disoriented or if they were in an accident. Their eyes also open spontaneously, they can follow commands, and they are aware of their environment
- V = This stands for Voice. This means the patient is conscious enough to respond to verbal stimuli and can respond either through speech (or a groan), opening their eyes, or moving certain limbs when a professional prompts them to do so.
- P = This stands for Pain. This means that the patient is not conscious enough to respond to verbal stimuli and commands, but they are conscious enough to respond to painful stimuli.
- U = This stands for Unconscious. This means the patient isn’t conscious and won’t respond to anything.
Printable AVPU Scale
Download this AVPU Scale to designate an appropriate level of consciousness for a patient.
How to use the AVPU Scale
The AVPU Scale itself is easy to use. We will provide directives on what to do when checking on the patient (though, if you are a healthcare professional or provider, you should know what to do).
If the patient is alert and fully awake, immediately mark them as A on the AVPU Scale.
If the patient is unconscious, you have to do the following:
- Seek medical help. Dial an emergency hotline if you have to or have someone else do it.
- Try to get them to respond to verbal stimuli. Talk to them. Yell, “WAKE UP!” or something similar. If they respond to verbal stimuli, mark them as V on the AVPU Scale.
- If they do not respond to verbal stimuli, you’ll have to resort to pain stimuli. You can pinch them, squeeze a body part, or rub their sternum to see if they respond. If they respond to pain stimuli, mark them as P on the AVPU Scale.
- If they do not respond to verbal or pain stimuli at all, they are entirely unconscious. Mark them as U on the AVPU Scale.
While you wait for EMTs or paramedics to arrive, continue monitoring their consciousness.
If they have any wounds, try stopping the bleeding. If they have open fractures, cover them.
If you are a first aider using the scale, check the patient’s pulse using an oximeter. If the result of the oximeter is below 94%, provide the patient with oxygen therapy until the ambulance arrives.
AVPU Scale Example
Now you know what the AVPU Scale is all about and what you’re supposed to do when using it, check out our AVPU Scale template. Our template has tickboxes for you to specify the consciousness level of your patient. It also has an additional comments box for you to write down observations you’ve made while the patient was unconscious, what you tried doing to rouse them, what happened at the scene, what treatments are being provided, and what operational procedures they are undergoing.
If you like what you see and believe our template will benefit your work, especially when assessing unconscious patients, feel free to download it! You can print it or engage with the PDF on a work device. We recommend you print copies instead since you’re not likely to bring a laptop or computer in settings like operation rooms.
Download this AVPU Scale Example (Sample) here:
When is it best to use the AVPU Scale?
The AVPU Scale was designed to assess the level of consciousness of patients, so the most appropriate time to use this is when you are dealing with an unconscious patient.
An example of a good time to use the AVPU Scale is when an accident occurs somewhere (let’s go with vehicular), and people are knocked unconscious because of the impact. Let’s stipulate that you’re a first-aid responder who happened to be in the area and saw the accident. The first thing to do is ensure the people involved in the accident are out of harm’s way and can be placed in a recovery position if they are unconscious. If they are unconscious, you should check if they respond to verbal stimuli. If not, try pain stimuli.
Another appropriate time would be when a patient is rushed to the hospital because they fell unconscious due to an illness or injury. One of the first things you should do is check if you can rouse them with verbal stimuli, then pain stimuli if the former doesn’t work. Whichever the result, mark accordingly on the scale before having the medical team perform a procedure like the ABCDE Assessment, which is supposed to stabilize the patient.
What are the benefits of using the AVPU Scale?
It is standardized and can rapidly assess a patient’s level of consciousness.
The AVPU Scale is a widely used assessment tool, and every healthcare professional using it will be subject to following its structure of gauging a patient’s consciousness. Not only that, but the AVPU Scale allows healthcare professionals to rapidly assess a patient’s level of consciousness through the simplicity of its instructions. Based on this, it makes it easier to relay information to EMTs and paramedics that arrive on the scene or to other healthcare professionals who will handle the patient after being assessed using the scale.
It can be used to monitor a patient’s consciousness every now and then.
If you’re a first aid responder and you’ve called for medical help, you can use this scale to monitor the unconscious person every now and then while you wait for medical help to arrive. Even if you marked them as unconscious during your first assessment of them doesn’t mean they will be unconscious for the rest of the wait. It’s best to check if you can rouse them every few minutes while waiting for medical help, then jot down on the scale or inform EMTs and paramedics how long it took before a patient began to respond to stimuli or if the patient was unconscious the whole time.
It can be used in a variety of emergency settings.
When assessing a patient for their level of consciousness, it’s very likely that the patient is in an emergency situation. The AVPU Scale can be used in numerous emergency situations, including sites of accidents, emergency rooms, intensive care units, and even settings where medical resources are limited. Even if healthcare professionals don’t have a sheet for the AVPU Scale, they can still assess the patient based on the scale’s criteria, then just relay the assessment results to paramedics, EMTs, or the next group handling the patient.
Commonly asked questions
The AVPU Scale is one of the most commonly used assessments in healthcare. Any healthcare professional can use this because the assessment is standardized. Most of the time, this is used by those who work in emergency rooms or any type of medical work that involves unconscious patients. Even first-aid responders can use it.
The AVPU is more simplified and has no numerical values to assign for each result. This makes it faster to accomplish. On the other hand, the Glasgow Coma Scale has scores, and the person using it has to assess if a person’s eyes are open, as well as their verbal and motor responses.
Yes. It would be best to get some first-aid training, though. That way, you know how to assess an unconscious patient using the scale and know how to take care of them until medical help arrives.
