Levels of Response AVPU:


The AVPU scale (Alert, Voice, Pain, Unresponsive) is a system, which is taught to healthcare professionals and first aiders on how to measure and record the patient's level of consciousness. It is a simplification of the GCS Scale (Glasgow Coma) which assesses a patient's response using Eyes, Voice and Motor skills as measures.


The AVPU has only one of four possible outcomes:

1. Alert

Patient is fully awake (though not necessarily orientated), will have spontaneously open eyes, and will respond to voice (thought may be confused). They will have bodily motor function.


2. Voice

The patient makes some sort of response when you talk to them. This could be through the eyes, which open when you speak to them, or by voice which may only be as little as a grunt. Or, it could be by moving a limb when prompted to do so by the rescuer.


3. Pain

A patient may respond by using any of the three components when pain stimulus is used on them (Eyes, Voice, Movement). Recognised methods for causing pain are pinching the ear or pressing into the bed of a fingernail. A fully conscious patient will locate the pain and push it away, whereas a patient who is not alert and not responded to voice may only manifest involuntary flexion or extension of a limb. Performing pain stimulus should be used with caution as in extreme circumstances this could be considered assault.


4. Unresponsive

This outcome is noted if the patient does not give any Eye, Voice or Motor response to voice or pain.


In first aid, an AVPU score less than A is a good indication of the need to get further help.



  • If patient conscious level is below 'A' seek medical help.
  • Monitor patient's level of response until medical help arrives.
  • An unconscious patient is serious and the priority here is the patient's airway.
  • Place in recovery position.
  • Dial 999.
  • Treat any bleeding or cover open fractures.
  • If first aiders have oxygen therapy, place pulse oximeter on patients finger and take reading, if below 94% place patient on oxygen therapy.


We hope you find this article useful. This is one in an alphabetical series of articles addressing various symptoms and their first aid treatments. If you would like more information on related resuscitation and first aid training, please get in touch.


You might also be interested in our blog. In this particular post, Sheila Mithard explains why being a paramedic is like being a detective inspector.


You can also sign-up to our newsletter here or at the bottom of our homepage.


First Response. Training for life. Training to save a life.


First Response Resuscitation & First Aid Training Ltd

9 Counterpool Road, Kingswood, Bristol BS15 8DQ

Tel: 0117 9496201



Registered Office:

86 Shirehampton Road, Stoke Bishop, Bristol BS9 2DR

Company No. 06983048. Registered in England & Wales


Information Commissioner's Office (Data Protection Register): Registered Number Z1874 429


Terms & Conditions | Disclaimer

Cookies Policy | Privacy Policy | Coronavirus


© 2021 First Response. All rights reserved

Latest News

Resupply of Auto-injectors announced

Resupply of Auto-injectors announced Bausch & Lomb have announced that the 300 and 500 microgram...

Read More ...

Study of the quality of face masks

Study of the quality of face masks The quality of face masks healthcare workers wear makes a huge...

Read More ...

HPC reg logo CMYK    CPDcertified    CPDmember