AVPU is a very basic assessment of a person’s level of consciousness and is very commonly used in both First Aid and Pre-hospital care because of its simplicity and ease of use. Any LOC response of less than A (meaning alert) is a signal for First Aiders to call for professional assisstance and transport of the patient to a hospital.
For paramedics, an AVPU assessment is generally performed as they walk through the door and greet a patient, where as a more detailed and thorough assessment of a patient’s neurological response is performed through an accurate Glasgow Coma Scale.
The mneumonic AVPU refers to the basic scale of consciousness and identifies the following levels of consciousness:
A – The patient is awake and alert. This does not necessarily mean that they are orientated to time and place or neurologically responding normally.
V – The patient is not fully awake, and will only respond to verbal commands or become roused after verbal stimuli.
P – The patient is difficult to rouse and will only respond to painful stimuli, such as nail bed pressure or trapezius pain.
U – The patient is completely unconscious and unable to be roused.
Case study involving AVPU
You are called to a patient who has fallen off his bike while not wearing a helmet. When you arrive you find that he is not awake and does not respond to you when you ask him to open his eyes and tell you his name. You place firm pressure on his nail bed and then squeeze his trapezius. He then squirms and tries to move away. This patient will score a P under the AVPU assessment and has a significantly lowered level of consciousness.