Reticular Formation Quiz

See ACVPU Scale. Option E is correct. ACVPU is the UK version of the older AVPU scale, and it is the consciousness check recorded on routine hospital observation charts (the bedside charts where staff record vital signs such as pulse, blood pressure and temperature). AVPU grades a patient's level of consciousness by what it takes to get a response: Alert, responds to Voice, responds to Pain or Unresponsive. The assessment is done in sequence and only one category is recorded, so if the patient responds to voice, there is no need to test their response to pain. ACVPU adds new confusion, meaning new-onset confusion, disorientation or agitation in a patient whose mental state was previously normal. It is one of the six measurements in the National Early Warning Score 2 (NEWS2), the UK scoring system that helps ward staff spot patients who are getting worse, and any category other than alert prompts review by the medical team. Its strength is speed and simplicity, so it can be repeated at every set of observations. Its weakness is that it is coarse (it has only a few broad categories), so when a finer measure is needed, the Glasgow Coma Scale is used. Memory aid: read ACVPU from left to right as a slide from fully awake to completely unresponsive.

• Scale: ACVPU is the UK version of the AVPU scale, recorded on routine observation charts and part of NEWS2.
• Categories: AVPU grades alert, responds to voice, responds to pain or unresponsive, and ACVPU adds new confusion.
• Recording: only one category is recorded, so there is no need to test pain if the patient responds to voice.
• Limit: it is coarse, so the Glasgow Coma Scale is used when a finer measure is needed.