Purpose: To evaluate a patient's level of coma using the Dull Outline of UnREsponsiveness (FOUR) score of Wijdicks et al.						Citations with documentation. 17.01.10	Medal Project 2005. See disclaimer.
data	enter
Are you evaluating a patient's level of coma? (Y or N)		:-):-):-)
Are the corneal reflexes present? (Y or N)		:-):-):-)						1
Is the cough reflex present? (Y or N)		:-):-):-)						1
Is the patient intubated? (Y or N)		:-):-):-)						1
enter an "x" in the appropriate column for each finding (give only 1 answer per row)
	present both pupils	one pupil wide and fixed	absent both pupils
pupil reflex							Yes	3
	above ventilator rate	breathes at ventilator rate
breathing on ventilator							Yes	1
	:-):-):-)	:-):-):-)	:-):-):-)	:-):-):-)
:-):-):-)							Yes	0
	open and tracking or blinks on command	eyelids open but eyes not tracking	eyelids closed but open to loud voice	eyelids closed but open to pain	eyelids closed and do not open with pain
eyelid and eye response							Yes	2
	makes sign	localizing response to pain	flexion response to pain	extension response to pain	no response to pain	generalized myoclonus status
motor response							Yes	0
calculate	result
data complete?	Yes
evaluation appropriate?	Yes	:-):-):-)
FOUR score	5	out of 16
points for brainstem reflexes	2