FOUR Score Coma Scale in Medical Intensive Care

This relatively new coma assessment scale performed well in predicting outcome in medical intensive care, but it needs further validation.

For several decades, clinicians have struggled to find the most useful and reliable coma assessment scale. The Glasgow Coma Scale (GCS) is widely used and accepted but gives relatively limited information about brainstem function, eye opening and tracking, and respiratory patterns. Its usefulness is substantially limited for intubated patients, realistically the population to which coma scales are most appropriately applied. A group at the Mayo Clinic have developed and validated the FOUR (Full Outline of UnResponsiveness) score, a tool that provides significantly more information about brainstem function than the GCS and maintains usefulness for intubated patients. To date, the FOUR score has been used primarily by those trained in the neu…

Reviewing Author

David M. Greer, MD, MA