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Lektion 1, Thema 1
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Level of Consciousness and Temperature

Level of Consciousness (AVPU)

Patients with acute illness may develop a Glasgow Coma Scale (GCS) <15. This is an important sign of acute clinical deterioration requiring urgent clinical assessment.

The AVPU acronym is used within Healthcare at Home to assess level of consciousness;

  • Alert The patient is fully awake and opens eyes spontaneously, will respond to voice

and will have motor function.

  • Verbal The patient responds only to verbal stimuli.
  • Pain The patient responds only to painful stimuli.
  • Unresponsive The patient shows little or no eye, voice or motor response to any stimuli.

Scoring to be applied to level of consciousness (AVPU) in accordance with NEWS is as follows;

Level of ConsciousnessA AlertV VerbalP PainU Unresponsive
Score0333

Temperature

Temperature is one of the ‘vital signs’ and should be regularly measured and recorded. It is especially important if the patient has any type of likely, suspected or confirmed infection and especially in neutropenic patients, and for detecting and recognising sepsis.

Both pyrexia and hypothermia are included in NEWS, reflecting the fact that extremes of temperature are sensitive markers of acute illness severity, sepsis and physiological disturbance. The ‘Surviving Sepsis’ campaign defines one of the parameters of sepsis as having a core body temperature of <35°C, which can become fatal at <32°C (www.survivingsepsis.org).

Scoring to be applied to body temperature in accordance with NEWS is as follows;

Body Temperature (°C)>39.138.1 – 39.036.1 – 38.035.1 – 36.0<35.0
Score21013