Simple bedside assessment of level of consciousness: comparison of two simple assessment scales with the Glasgow Coma scale

A F McNarry; D R Goldhill

doi:10.1111/j.1365-2044.2004.03526.x

Simple bedside assessment of level of consciousness: comparison of two simple assessment scales with the Glasgow Coma scale

Anaesthesia. 2004 Jan;59(1):34-7. doi: 10.1111/j.1365-2044.2004.03526.x.

Authors

A F McNarry¹, D R Goldhill

Affiliation

¹ Department of Anaesthesia and Critical Care, Royal London Hospital, Barts and the London NHS Trust, Alexandra Wing, The Royal London Hospital, Whitechapel, London E1 1BB, UK. al@thegasman.fsnet.co.uk

PMID: 14687096
DOI: 10.1111/j.1365-2044.2004.03526.x

Abstract

Neurological assessment is an essential component of early warning scores used to identify seriously ill ward patients. We investigated how two simple scales (ACDU - Alert, Confused, Drowsy, Unresponsive; and AVPU - Alert, responds to Voice, responds to Pain, Unresponsive) compared to each other and also to the more complicated Glasgow Coma Scale (GCS). Neurosurgical nurses recorded patients' conscious level with each of the three scales. Over 7 months, 1020 analysable measurements were collected. Both simple scales identified distinct GCS ranges, although some overlap occurred (p < 0.001). Median GCS scores associated with AVPU were 15, 13, 8 and 6 and for ACDU were 15, 13, 10 and 6. The median values of ACDU were more evenly distributed than AVPU and may therefore be better at identifying early deteriorations in conscious level when they occur in critically ill ward patients.

Publication types

Comparative Study

MeSH terms

Attitude of Health Personnel
Consciousness
Critical Care / methods*
Glasgow Coma Scale*
Humans
London
Neurologic Examination / methods
Nursing Assessment / methods
Point-of-Care Systems*
Reproducibility of Results
Severity of Illness Index*
Unconsciousness / diagnosis*