FOUR Score Edges Out Glasgow Coma Scale in ICU Assessments

Did you know? A newer consciousness assessment tool slightly outperforms the widely-used Glasgow Coma Scale in ICU and emergency settings.

The Full Outline of UnResponsiveness (FOUR) score showed higher reliability and validity than the traditional Glasgow Coma Scale (GCS) when nurses and physicians assessed consciousness levels in critically ill patients. A systematic review of 6 studies found both tools demonstrated excellent performance overall, but the FOUR score had a slight edge. The GCS has been a clinical staple for decades, yet the FOUR score may offer improvements for evaluating patients in intensive care units and emergency departments. Both assessment methods are linked to accurate consciousness evaluation, though the FOUR score’s enhanced psychometric properties suggest it could serve as a promising alternative in critical care settings where precise neurological monitoring matters most.

Source: PMID 38777642 (Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, 2025)