Validation of the Full Outline of Unresponsiveness (FOUR) scale for conscious state in the emergency department: Comparison against the Glasgow coma scale

Abstract

Objectives: To determine (a) the inter-rater reliability of pairs of emergency doctors' and/or nurses' ratings of the. Glasgow Coma Scale (GCS) and the Full Outline of Unresponsiveness (FOUR) Scale in emergency department (ED) patients, (b) the concurrent validity of the FOUR Scale using the GCS as the reference scale and (c) doctors' and nurses' knowledge and attitudes towards the GCS and FOUR Scale. Methods: A prospective observational study was conducted using staff participants' ratings for a convenience sample of ED patients requiring quantification of conscious state. Participating doctors and nurses attended a formal training session on the correct use of the GCS and FOUR Scale. Pairs..