FOUR Score (Coma Scale)
Encyclopedia
The FOUR Score is a clinical grading scale designed for use by medical professionals in the assessment of patients with impaired level of consciousness. It was developed by Dr. Eelco F.M. Wijdicks and his colleagues in Neurocritical care at the Mayo Clinic
in Rochester, Minnesota
.
"FOUR" in this context is an acronym for "Full Outline of UnResponsiveness."
The FOUR Score is a 17-point scale (with potential scores ranging from 0 to 16). Decreasing FOUR Score is associated with worsening level of consciousness. The FOUR Score assesses four domains of neurological function: eye responses, motor responses, brainstem reflexes, and breathing pattern.
The rationale for the development of the FOUR Score was to create a clinical grading scale for the assessment of patients with impaired level of consciousness that can be used in patients with or without endotracheal intubation. The main clinical grading scale in use for patients with impaired level of consciousness has historically been the Glascow Coma Scale (GCS), which cannot be administered to patients with an endotracheal tube (one component of the GCS is the assessment of verbal responses, which are not possible in the presence of an endotracheal tube.)
The FOUR score has been validated with reference to the Glascow Coma Scale in several clinical contexts, including assessment by physicians in the Neurocritical Care Unit, assessment by intensive care nurses, assessment of patients in the medical intenvsive care unit (ICU), and assessment of patients in the Emergency Department
. Comparison of the inter-observer reliability of the FOUR Score and the GCS suggests that the FOUR Score may have a modest but significant advantage in this particular measure of test function.
Mayo Clinic
Mayo Clinic is a not-for-profit medical practice and medical research group specializing in treating difficult patients . Patients are referred to Mayo Clinic from across the U.S. and the world, and it is known for innovative and effective treatments. Mayo Clinic is known for being at the top of...
in Rochester, Minnesota
Rochester, Minnesota
Rochester is a city in the U.S. state of Minnesota and is the county seat of Olmsted County. Located on both banks of the Zumbro River, The city has a population of 106,769 according to the 2010 United States Census, making it Minnesota's third-largest city and the largest outside of the...
.
"FOUR" in this context is an acronym for "Full Outline of UnResponsiveness."
The FOUR Score is a 17-point scale (with potential scores ranging from 0 to 16). Decreasing FOUR Score is associated with worsening level of consciousness. The FOUR Score assesses four domains of neurological function: eye responses, motor responses, brainstem reflexes, and breathing pattern.
The rationale for the development of the FOUR Score was to create a clinical grading scale for the assessment of patients with impaired level of consciousness that can be used in patients with or without endotracheal intubation. The main clinical grading scale in use for patients with impaired level of consciousness has historically been the Glascow Coma Scale (GCS), which cannot be administered to patients with an endotracheal tube (one component of the GCS is the assessment of verbal responses, which are not possible in the presence of an endotracheal tube.)
The FOUR score has been validated with reference to the Glascow Coma Scale in several clinical contexts, including assessment by physicians in the Neurocritical Care Unit, assessment by intensive care nurses, assessment of patients in the medical intenvsive care unit (ICU), and assessment of patients in the Emergency Department
Emergency department
An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...
. Comparison of the inter-observer reliability of the FOUR Score and the GCS suggests that the FOUR Score may have a modest but significant advantage in this particular measure of test function.