FOUR Score - Medscape Reference

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Questions

1.Eye Response?2.Motor Response?3.Brainstem Reflexes?4.Respiration?

About

While the Glasgow Coma Scale (GCS) has been widely adopted to grade coma, it is limited by its inabillity to assess the verbal score in intubated patients and test brainstem reflexes. The FOUR (Full Outline of UnResponsiveness) score has some advantages to the GCS scale as it provides greater neurological detail and can recognize a locked-in syndrome as well as different stages of brain herniation. The FOUR score may also provide additional prognostic information in patients with low scores.

The FOUR score consists of four components (eye, motor, brainstem, and respiration), with a maximum score of 4 for each item.

References

Wijdicks EF et al.

Validation of a new coma scale: The FOUR score.Annals of Neurology 2005, 58 (4): 585-93The FOUR Score calculator is created by QxMD.Default Units

1. Eye Response?

Eyelids open or opened, tracking or blinking to commandEyelids open but not to trackingEyelids closed but opens to loud voice or shoutingEyelids closed but opens to painEyelids remain closed to painCreated by0/4 completedStart

About

While the Glasgow Coma Scale (GCS) has been widely adopted to grade coma, it is limited by its inabillity to assess the verbal score in intubated patients and test brainstem reflexes. The FOUR (Full Outline of UnResponsiveness) score has some advantages to the GCS scale as it provides greater neurological detail and can recognize a locked-in syndrome as well as different stages of brain herniation. The FOUR score may also provide additional prognostic information in patients with low scores.

The FOUR score consists of four components (eye, motor, brainstem, and respiration), with a maximum score of 4 for each item.

References

Wijdicks EF et al.

Validation of a new coma scale: The FOUR score.Annals of Neurology 2005, 58 (4): 585-93The FOUR Score calculator is created by QxMD.

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