Emergency Severity Index Implementation Handbook: Table 3-2. Four Levels of the AVPU Scale

You Are Here: AHRQ Home > Quality Assessment > Measuring Healthcare Quality > Emergency Severity Index, Version 4

AVPU Level	Level of Consciousness
A	Alert. The patient is alert, awake and responds to voice. The patient is oriented to time, place and person. The triage nurse is able to obtain subjective information.
V	Verbal. The patient responds to verbal stimuli by opening their eyes when someone speaks to them. The patient is not fully oriented to time, place, or person.
P	Painful. The patient does not respond to voice, but does respond to a painful stimulus, such as a squeeze to the hand or sternal rub. A noxious stimulus is needed to elicit a response.
U	Unresponsive. The patient is nonverbal and does not respond even when a painful stimulus is applied.

Source: Emergency Nurses Association, 2000.