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Title

Comparison of Three Consciousness Assessment Scales in Poisoned Patients and Recommendation of a New Scale: AVPU Plus

Year: 1394
COI: JR_PJMT-4-2_001
Language: EnglishView: 111
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Authors

Ali Rajabi Kheirabadi - Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
Jamshid Tabeshpour - Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
Reza Afshari - Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran | British Columbia Centre for Disease Control, Vancouver, Canada

Abstract:

Background: Few methods have been introduced to assess the level of consciousness in critically-ill patients. This study was designed to evaluate how the AlertVerbalPainfulUnresponsive (AVPU) responsive scale corresponds with the Glasgow Coma Scale (GCS) and Richmond Agitation-Sedation Scale (RASS) scores in drug-poisoned patients and to devise an augmented AVPU scale. Methods: In this prospective study, patients with diagnosis of acute drug poisoning were included and their level of consciousness was assessed using GCS, RASS and AVPU scales. Results: Overall, 165 poisoned patients (59% female) were studied. According to AVPU scale, 123 patients (74.5%) were graded as alert , 26 patients (15.8%) as responsive to verbal stimulation , 10 patients (6.1%) as responsive to painful stimulation , and 6 patients as unresponsive (3.6%). AVPU grades of alert , responsive to verbal stimulation , responsive to painful stimulation and unresponsive corresponded with median [IQR] GCS scores of 15 [15–15], 13 [12–13], 8 [7–10] and 6 [5–6], and median [IQR] RASS scores of -1 [-1 – +1], -2 [-3 – -1], -3 [-4 – -1], -5 [-5 – -5], respectively. By taking the median of RASS scores corresponding with each AVPU grade, an augmented AVPU scale for the assessment of consciousness was devised. The first proposed version of AVPU plus includes 14 qualitative grades of consciousness. By application of this scale, clinicians can evaluate both the alertness/attentiveness and arousal/excitability of poisoned and critical patients. Conclusion: The AVPU plus is a new scale designed for more detailed assessment of neurologic status of poisoned and critical patients. The prognostic-ability, reliability and validity of the scale should be investigated in future studies.

Keywords:

Glasgow Coma Scale, Psychomotor agitation, Sedation, Unconsciousness, Weights and Measures

Paper COI Code

This Paper COI Code is JR_PJMT-4-2_001. Also You can use the following address to link to this article. This link is permanent and is used as an article registration confirmation in the Civilica reference:

https://civilica.com/doc/890676/

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Rajabi Kheirabadi, Ali and Tabeshpour, Jamshid and Afshari, Reza,1394,Comparison of Three Consciousness Assessment Scales in Poisoned Patients and Recommendation of a New Scale: AVPU Plus,,,,,https://civilica.com/doc/890676

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