which 1, 2, 3 and 4 correspond to certain attributes, such as time, person, place, and event. For example, a fully alert patient might be considered "alert and oriented x 4" if they could correctly identify the time, their name, their location, and the event. EMS crews may begin with an AVPU assessment, to be followed by a GCS assessment if the AVPU score is below "A." Limitations The AVPU scale is not suitable for long-term neurological observation of a patient; in this situation, the Glasgow Coma Scale is more appropriate. Comparison with other classification systems When compared to the Glasgow Coma Scale (GCS) the AVPU classification of alertness has been suggested to correspond in the following manner: Alert = 15 GCS Voice Responsive = 13 GCS Pain Responsive = 8 GCS Unconscious/DOA = 3 GCS (Kelly, Upex and Bateman, 2004) The AVPU scale can also be compared to the Pediatric Glasgow Coma Scale (PGCS). The PGCS corresponds with the AVPU classification of consciousness in the following manner: Alert = 11–15 PGCS Voice Responsive = 5–15 PGCS Pain Responsive = 4–12 PGCS Unconscious/DOA = 3–5 PGCS References Diagnostic emergency medicine First aid