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Hoffmann, Florian; Schmalhofer, Michael; Lehner, Markus; Zimatschek, Sebastian; Grote, Veit and Reiter, Karl (2016): Comparison of the AVPU Scale and the Pediatric GCS in Prehospital Setting. In: Prehospital Emergency Care, Vol. 20, No. 4: pp. 493-498

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Abstract

Objective: The pediatric Glasgow coma scale (pGCS) is a consciousness score that, although widely applied, requires skill to apply. The AVPU scale uses four simple categories (Alert;Verbal response;response to Pain;Unresponsive), but has not been studied in a large pediatric population. We compared the performance of the AVPU and pGCS scales in a large pediatric cohort in an acute, prehospital setting. Methods: In a six-month-long prospective cohort study, AVPU and pGCS scores were determined by emergency physicians in children less than 10years of age at their first prehospital encounter. Results: We included 302 children (median age 2.3years) with a broad spectrum of diagnoses. Data were complete for 287 children. AVPU and pGCS scores showed good a correlation in the extreme categories A and U (positive predictive values of 98% and 100%, respectively). Corresponding pGCS scores for each AVPU category were as follows: 11-15 for A;5-15 for V;4-12 for P;and 3-5 for U. The positive predictive value to detect patients with pGCS 8 for AVPU category V was 100%. Conclusions: We demonstrated good correlation of simple and fast consciousness AVPU scoring to the standard pGCS in a large cohort of pediatric patients in a prehospital setting. The AVPU category V identifies patients with a pGCS of or exceeding 8 and, therefore, identifies children at low risk requiring more invasive procedures or intensive care treatment. Key words: Glasgow coma scale (GCS);Alert-verbal-pain-unresponsive-score;AVPU-score;consciousness assessment;children, pediatric emergency

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