Level of Consciousness

LOC (Level of Consciousness) is a measurement of a person’s arousability and responsiveness to stimuli from the environment. Any change in LOC may be due to a medical condition and requires immediate attention.

In some cases, some people intentionally alter their LOC, but one should still consider other causes are responsible and should not rule out that possibility

We can use the AVPU (pronounced avpoo) scale to help determine the level of consciousness.

A – Alert and Oriented

  • A person who is alert but only knows who they are is said to be a(alert) & o(oriented) x (times) 1 (A&Ox1)
  • A person who knows their name and where they are is said to be A&Ox2
  • A person who knows their name, where they’re at, and what time it is is said to be A&Ox3
  • A person who knows their own name, where they’re at, what time it is, and what happened, is said to be A&Ox4

V – Verbal (responds to verbal stimuli)

P – Pain ( only responds to painful stimuli, such as reacting to a brisk rub of the breastbone with the knuckles)

U – Unresponsive (does not respond to any stimuli)

One doesn’t need to go through the whole AVPU scale once they have ascertained at which level he/she responds – Clearly, if a person responds to verbal stimuli, you don’t want to apply a pain test.

A person who is not at least aware of who they are may be experiencing altered mental status due to medical reasons.

Altered Mental Status

No I don’t mean what you’ve experienced when you’ve had a few too many drinks, although, it can help explain some things. It is a term used to best describe one of the signs we look for in a person when responding to a medical emergency. General changes in brain function, such as confusion, amnesia (memory loss), loss of alertness, loss of orientation (not cognizant of self, time, or place), defects in judgment or thought, poor regulation of emotions, and disruptions in perception, psychomotor skills, and behavior are all AMS.

What causes it?

The list is long, but some of the things that causes it are alcoholism, hypothermia, bipolar disorder, dementia, depression, heat stroke, HIV, hypoglycemia, kidney failure, listeria, liver cancer, malaria, meningitis, narcolepsy, pregnancy, schizophrenia, seizure (Epilepsy), sepsis, shock, stroke, brain infections/abscesses, brain tumor, decompression sickness, diabetic ketoacidosis, drug abuse, liver failure, medications, meningitis, poisoning, respiratory failure, severe hemorrhage, toxins, withdrawal from drug or alcohol, etc. The list goes on and on. I know what your thinking, how in the world am I suppose to accurately determine what is wrong with a person with a list longer than Santa’s naughty and nice list? Well, you’re not expected to, but some of the more common reasons can be narrowed down by using the useful mneumonic AEIOU TIPS

A – Alcohol

E – Epilepsy (Seizure)

I – Insulin (diabetes)

O – Overdose (Medication, drugs, poison, toxins)

U – Underdose (medication)

T – Trauma (shock)

I – Infection

P – Psychosis

Level of Consciousness

S – Stroke

Sure, these tools may not tell you the whole story, but they can help you take a decisive course of action.

As always, this isn’t the be all, end all bit of information on medical procedures. It is up to the individual to do their due diligence and seek proper training from qualified sources.