The AVPU Protocol

Checking Levels of Consciousness

AVPU - What is it ?
The AVPU protocol is a very simple way of checking the level of concsiousness of a casualty.

A

As you approach the casualty, are they ALERT ?  Are they awake and able to communicate with you ? 


If so, they are conscious.

V

Ok ... so they may not appear awake or communicative, but perhaps they are just lying with their eyes shut, perhaps even dozing off !   That being the case, do they respond to your VOICE ?   


If they do, they are conscious.

P

So we should be starting to worry now.  they are not ALERT, they have not responded to your VOICE, we need to see if they respond to PAIN.  To do this we could pinch their earlobes, or do some other irritating (but not dangerous) thing to see if they respond to it.  We need it to be a bit painful though, because the pain response is involuntary ... some mischief maker could ignore a gentle pat on the back of the hand !

U

If they are not ALERT, and have responded to neither your VOICE or PAIN, then we can assume that they are UNRESPONSIVE.

But does this mean they are unconscious ?

Not necessarily ... it could mean they are DEAD !

What we need to do is to determine whether they are unresponsive because they are unconscious, or whether they are unresponsive because they are dead, as this will dictate our 'next steps' !  You can learn more about how we go about making this decision in the red panel of this webpage.

The process described above, though, is the AVPU Protocol, and it's one you need to know !

What Causes Unconsciousness ? 
There are many reasons for a casualty losing consciousness.  They include ... 

  • Altitude
  • Anaemia
  • Asthma
  • Bleeding
  • Thrombosis
  • Chest Injury/crushing
  • Collapsed Lung
  • Choking
  • Diabetes
  • Drowning
  • Electric Shock
  • Heart Attack/Angina
  • Head Injury
  • A medical condition
  • Overdose
  • Poisoning
  • Seizure
  • Smoke/gas inhalation
  • strangulation
  • Stroke
  • Shock
Dealing with an unresponsive casualty
The video below explain and demonstrates what is called the 'Primary Survey', the process of approaching a casualty safely and determining their level of consciousness.

This Primary survey also includes checking for breathing, and checking circulation.

© Copyright Simon Watson