The ACDU scale, like AVPU, is easier to use than the GCS and produces similarly accurate results. Responsiveness to pain is determined with a mild painful stimulus such as a pinch moaning or withdrawal from the stimulus is considered a response to pain. To determine responsiveness to voice, a caregiver speaks to, or, failing that, yells at the person. The AVPU scale is another means of measuring LOC: people are assessed to determine whether they are alert, responsive to verbal stimuli, responsive to painful stimuli, or unresponsive. If feature 1 and 2 are present along with 3 or 4 then patient is assessed to have delirium by CAM-ICU scale.
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