AVPU — Reference Guide

? AVPU: Assessing Level of Response

Quick tool for checking a casualty’s level of consciousness

What is AVPU?

The AVPU scale is a quick and simple tool used by first aiders to assess and record a person’s level of consciousness. Each letter stands for a different level of responsiveness:

? A – Alert

  • The person is awake and responsive.
  • They can talk, answer questions, and are aware of their surroundings.
  • They may be confused or disoriented, but they are conscious.

? V – Voice

  • The person responds to verbal stimuli (e.g., when you talk or shout).
  • They may open their eyes or make a sound, but they are not fully alert.

? P – Pain (or Physical Stimulus)

  • The person does not respond to voice, but reacts to a physical stimulus (e.g., gentle shake, tap on shoulders, squeeze fingers).
  • This indicates a lower level of consciousness. Avoid causing pain—use gentle physical prompts instead.

? U – Unresponsive

  • The person does not respond to voice or pain.
  • They are completely unresponsive and unconscious.

✅ When to Use AVPU

  • As part of your primary survey in a first aid situation (after checking airway, breathing, and circulation).
  • To monitor changes in a casualty’s condition.
  • To decide when to escalate care (e.g., call emergency services).

⚠️ Important Notes

  • If the casualty is anything other than Alert, seek emergency medical help.
  • AVPU is often used after the Primary Assessment: checking for Danger, Response, Airway, Breathing, and Circulation (ABC).

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