The AVPU scale is a system to allow first responders to assess a patient's level of consciousness. It is generally used as a rough guide in the field, with the Glasgow Coma Scale being the superior tool for hospitals and research.

Conducting an AVPU Assessment

The patient is assigned a letter based on their level of consciousness:

  1. Alert - The patient is fully awake, responding to voice, and opening eyes spontaneously. They are allowed to be confused.
  2. Verbal - The patient responds to verbal stimulation. These responses can be as little as a moan or quickly opening and shutting their eyes, or reaching out with their hand.
  3. Pain - The patient responds to painful stimulus based on an observable reaction from their eyes, motor function, or voice.
  4. Unresponsive - The patient does not respond.


  1. Lincoln, Matthew, McSheffrey eds. Essentials of Clinical Examination Handbook. 6th ed. Toronto, ON: University of Toronto Medical Society: 2010.