The FOUR score (Full Outline of UnResponsiveness), is a new coma scale (range 0-16) with 4 components (eye response, motor response, brainstem reflex, and respiration pattern) which was validated against the Glascow coma scale (GCS) in 100 medical ICU patients. The FOUR score and GCS were almost identical in their ability to predict poor neurologic outcome, and the FOUR score was able to be performed reliably (with excellent interrater reliability). It is also able to be performed in intubated patients. The FOUR score may become a popular coma scale in critically ill medical patients (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.