01/15/2026
One of the things that Safety-Educators does is EMS instruction, and for altered mental status situations, there are two tools as first responders that we can use in our assessment and documentation: AVPU and GCS. The first is easy, as it's just four items; if the patient doesn't respond to your greeting, you are practically at the destination (alert vs responds to voice vs responds to pain vs unresponsive). It's possible to teach this tool to non-EMS folks who take a first aid class, as it's otherwise easy enough to gauge.
GCS (Glasgow Coma Scale) is the other, and is a bit trickier. The Wikipedia entry on this is actually good (https://en.wikipedia.org/wiki/Glasgow_Coma_Scale), as it shows the parameters in a grid. I asked a student today how they gauge mentation. The student never heard the word 'mentation' before (insert cringe, but like always, turn a negative into a positive). My question was not meant to be condescending, but concise. Words matter, and as the education system continues to erode critical thinking, I was fortunate to be able to help the student not just with a new word, but to apply the logic of the scale to a patient assessment scenario and help to make them a better provider. Now, when they take a patient to the hospital, they are able to say with authority that the patient's mentation shows a specific GCS rating (along with a better assessed AVPU rating). In other words, helping the student to be the boss that they should talk like, as the makes for better care.