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Home > List Archives

AVPU trivia

Bjorn, Pret trauma-list@trauma.org
Wed, 20 Feb 2002 07:35:15 -0500


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Karim,
=20
I agree with your sentiments.  But they don't answer my question.
=20
Where did AVPU come from?
=20
I'm interested because I too think it's a sloppy, unscientific, =
meaningless
method of assessment.  Nonetheless, it's taught as a primary survey
component in PHTLS, TNCC, and ATLS. =20
=20
I'm alarmed at this consensus endorsement of a behavior which has =
little if
any scientific basis, and I spend a good deal of otherwise perfectly =
useful
time UN-teaching it to my friends and colleagues who actually work =
among
acutely injured patients.  Rather than simply spray around my opinion,
however, I'd like to assemble a small fund of knowledge on the topic.  =
Such
would include AVPU's history and origins.  I'm finding them elusive.
Probably says much about the subject.
=20
Thanks anyhow.
=20
Pret

-----Original Message-----
From: Karim Brohi [mailto:karim@trauma.org]
Sent: Tuesday, February 19, 2002 6:33 PM
To: trauma-list@trauma.org
Subject: RE: AVPU trivia


I thought AVPU had died and gone to heaven. =20
It was murdered in its sleep by the more robust and powerful Glasgow =
Coma
Scale.
=20
AVPU is essentially a bastardised GCS - and the weakest components of =
it.
If you wanted to trim the GCS (and why would you - it only takes 5 =
seconds)
you'd limit it to Best Motor Response (in the upper limb)
=20
AVPU is dead and gone.  Let it rest in peace.
=20
Karim
=20
PS.  The Glasgow Coma Scale is so powerful it's even, apparently, used =
in
Edinburgh
=20
=20

-----Original Message-----
From: trauma-list-admin@trauma.org =
[mailto:trauma-list-admin@trauma.org]On
Behalf Of Rosann Juska
Sent: 19 February 2002 07:27
To: trauma-list@trauma.org
Subject: Re: AVPU trivia


A-Alert
V-responds to Verbal
P- responds to Pain
U-unresponsive
=B8..=B7 =B4=A8=A8))  -:=A6:-
     =B8.=B7=B4 .=B7=B4=A8=A8))
   ((=B8=B8.=B7=B4  ..=B7=B4   -:=A6:-=20
  -:=A6:-    ((=B8=B8.=B7=B4*    =20
                   Rosann Juska


----- Original Message -----=20
From: Bjorn, Pret <mailto:pbjorn@emh.org> =20
To: Trauma-List (E-mail) <mailto:trauma-list@trauma.org> =20
Sent: Monday, February 18, 2002 1:02 PM
Subject: AVPU trivia

An oxymoron, I know...
=20
But does anyone know the origins of the AVPU mnemonic?  Who originally
recommended it?  And where might I find even one evidence-based =
endorsement?
I've been looking all day, suspect I know the answers, but I always =
test my
assumptions against the wisdom of the List.
=20
Thanks in Advance.
=20

Pret Bjorn
Trauma Coordinator
EMMC Trauma Program
489 State Street
Bangor, ME 04401
=20
207.973.7260 (office)
207.973.7673 (fax)
207.941.5085 (voice pager)
=20


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<BODY bgColor=#ffffff>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002>Karim,</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002></SPAN></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN class=200291812-20022002>I 
agree with your sentiments.&nbsp; But they don't answer my 
question.</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002></SPAN></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002><EM>Where did AVPU come from</EM>?</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002></SPAN></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN class=200291812-20022002>I'm 
interested because I too think it's a sloppy, unscientific, meaningless method 
of assessment.</SPAN></FONT><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002>&nbsp; Nonetheless, it's </SPAN></FONT><FONT 
color=#800000 face=Arial size=2><SPAN class=200291812-20022002>taught&nbsp;as a 
primary survey component in PHTLS, TNCC, and ATLS.&nbsp; </SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002></SPAN></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN class=200291812-20022002>I'm 
alarmed at this consensus endorsement of a behavior which has little if any 
scientific basis, and I spend a good deal of otherwise perfectly useful time 
UN-teaching it to my friends and colleagues who actually work among acutely 
injured patients.&nbsp; Rather than simply spray around my opinion, however, I'd 
like to assemble a small fund of knowledge on the topic.&nbsp; Such would 
include AVPU's history and origins.&nbsp; I'm finding them elusive.&nbsp; 
Probably says much about the subject.</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002></SPAN></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN class=200291812-20022002>Thanks 
anyhow.</SPAN></FONT></DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002></SPAN></FONT>&nbsp;</DIV>
<DIV><FONT color=#800000 face=Arial size=2><SPAN 
class=200291812-20022002>Pret</SPAN></FONT></DIV>
<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
  <DIV align=left class=OutlookMessageHeader dir=ltr><FONT face=Tahoma 
  size=2>-----Original Message-----<BR><B>From:</B> Karim Brohi 
  [mailto:karim@trauma.org]<BR><B>Sent:</B> Tuesday, February 19, 2002 6:33 
  PM<BR><B>To:</B> trauma-list@trauma.org<BR><B>Subject:</B> RE: AVPU 
  trivia<BR><BR></DIV></FONT>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff size=2>I thought AVPU 
  had died and gone to heaven.&nbsp; </FONT></SPAN></DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff size=2>It was murdered 
  in its sleep by the more robust and powerful Glasgow Coma 
  Scale.</FONT></SPAN></DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff size=2>AVPU is 
  essentially a bastardised GCS - and the weakest components of 
  it.</FONT></SPAN></DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff size=2>If you wanted 
  to trim the GCS (and why would you - it only takes 5 seconds) you'd limit it 
  to Best Motor Response (in the upper limb)</FONT></SPAN></DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff size=2>AVPU is dead 
  and gone.&nbsp; Let it rest in peace.</FONT></SPAN></DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff 
  size=2>Karim</FONT></SPAN></DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff size=2>PS.&nbsp; The 
  Glasgow Coma Scale is so powerful it's even, apparently, used in 
  Edinburgh</FONT></SPAN></DIV>
  <DIV><SPAN class=067233023-19022002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=067233023-19022002></SPAN>&nbsp;</DIV>
  <BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
    <DIV align=left class=OutlookMessageHeader dir=ltr><FONT face=Tahoma 
    size=2>-----Original Message-----<BR><B>From:</B> 
    trauma-list-admin@trauma.org [mailto:trauma-list-admin@trauma.org]<B>On 
    Behalf Of </B>Rosann Juska<BR><B>Sent:</B> 19 February 2002 
    07:27<BR><B>To:</B> trauma-list@trauma.org<BR><B>Subject:</B> Re: AVPU 
    trivia<BR><BR></FONT></DIV>
    <DIV><FONT color=#008080 face="Goudy Old Style">A-Alert</FONT></DIV>
    <DIV><FONT color=#008080 face="Goudy Old Style">V-responds to 
    Verbal</FONT></DIV>
    <DIV><FONT color=#008080 face="Goudy Old Style">P- responds to 
    Pain</FONT></DIV>
    <DIV><FONT color=#008080 face="Goudy Old Style">U-unresponsive</FONT></DIV>
    <DIV>¸..· ´¨¨))&nbsp; -:¦:-<BR>&nbsp;&nbsp;&nbsp;&nbsp; ¸.·´ 
    .·´¨¨))<BR>&nbsp;&nbsp; ((¸¸.·´&nbsp; ..·´&nbsp;&nbsp; -:¦:- <BR>&nbsp; 
    -:¦:-&nbsp;&nbsp;&nbsp; ((¸¸.·´*&nbsp;&nbsp;&nbsp;&nbsp; 
    <BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
    Rosann Juska<BR></DIV>
    <BLOCKQUOTE 
    style="BORDER-LEFT: #008080 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px; PADDING-RIGHT: 0px">
      <DIV style="FONT: 10pt arial">----- Original Message ----- </DIV>
      <DIV 
      style="BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: black"><B>From:</B> 
      <A href="mailto:pbjorn@emh.org" title=pbjorn@emh.org>Bjorn, Pret</A> 
</DIV>
      <DIV style="FONT: 10pt arial"><B>To:</B> <A 
      href="mailto:trauma-list@trauma.org" 
      title=trauma-list@trauma.org>Trauma-List (E-mail)</A> </DIV>
      <DIV style="FONT: 10pt arial"><B>Sent:</B> Monday, February 18, 2002 1:02 
      PM</DIV>
      <DIV style="FONT: 10pt arial"><B>Subject:</B> AVPU trivia</DIV>
      <DIV><BR></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=020215720-18022002>An oxymoron, I know...</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=020215720-18022002></SPAN></FONT>&nbsp;</DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=020215720-18022002>But does anyone know the origins of the AVPU 
      mnemonic?&nbsp; Who originally recommended it?&nbsp; And where might I 
      find even one evidence-based endorsement?&nbsp; I've been looking all day, 
      suspect I know the answers, but I always test my assumptions against the 
      wisdom of the List.</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=020215720-18022002></SPAN></FONT>&nbsp;</DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=020215720-18022002>Thanks in Advance.</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=020215720-18022002></SPAN></FONT>&nbsp;</DIV>
      <DIV><FONT color=#800000 face=Arial size=2>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000>Pret Bjorn</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000>Trauma Coordinator</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000>EMMC Trauma Program</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000>489 State Street</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000>Bangor, ME 04401</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000></SPAN></FONT>&nbsp;</DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000>207.973.7260 (office)</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000>207.973.7673 (fax)</SPAN></FONT></DIV>
      <DIV><FONT color=#800000 face=Arial size=2><SPAN 
      class=030133519-19052000>207.941.5085 (voice 
      pager)</SPAN></FONT></DIV></FONT></DIV>
      <DIV>&nbsp;</DIV></BLOCKQUOTE></BLOCKQUOTE></BLOCKQUOTE></BODY></HTML>

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