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Coma
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===Initial evaluation=== {{More citations needed section|date=August 2020}} In the initial assessment of coma, it is common to gauge the [[level of consciousness]] on the [[AVPU]] (alert, vocal stimuli, painful stimuli, unresponsive) scale by spontaneously exhibiting actions and, assessing the patient's response to vocal and painful stimuli.<ref>{{cite book |last1=Romanelli |first1=David |last2=Farrell |first2=Mitchell W. |title=StatPearls |chapter=AVPU Scale |date=2024 |publisher=StatPearls Publishing |chapter-url=http://www.ncbi.nlm.nih.gov/books/NBK538431/ |pmid=30860702 }}</ref> More elaborate scales, such as the [[Glasgow Coma Scale]], quantify an individual's reactions such as eye opening, movement and verbal response in order to indicate their extent of brain injury.<ref>{{cite book |last1=Jain |first1=Shobhit |last2=Iverson |first2=Lindsay M. |title=StatPearls |chapter=Glasgow Coma Scale |date=2024 |publisher=StatPearls Publishing |chapter-url=http://www.ncbi.nlm.nih.gov/books/NBK513298/ |pmid=30020670 }}</ref> The patient's score can vary from a score of 3 (indicating severe brain injury and death) to 15 (indicating mild or no brain injury).<ref>{{EMedicine|article|326643|Classification and Complications of Traumatic Brain Injury}}</ref> In those with deep unconsciousness, there is a risk of [[asphyxiation]] as the control over the muscles in the face and throat is diminished. As a result, those presenting to a hospital with coma are typically assessed for this risk ("[[airway management]]"). If the risk of asphyxiation is deemed high, doctors may use various devices (such as an [[oropharyngeal airway]], [[nasopharyngeal airway]] or [[endotracheal tube]]) to safeguard the airway.
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