FOUR Score Coma Scale Calculator

About this calculator

The FOUR Score (Full Outline of UnResponsiveness) is a neurological consciousness scale developed to assess severely impaired patients more precisely than the Glasgow Coma Scale, particularly when a patient is intubated and cannot produce a verbal response. It rates four components — eye response, motor response, brainstem reflexes, and respiration pattern — each from 0 to 4, for a combined total of 0 to 16.

Because it captures brainstem reflexes (pupillary, corneal, cough) and ventilator status directly, the FOUR Score can distinguish conditions like locked-in syndrome or brain death patterns that a verbal-dependent scale would miss. Neurologists, neurosurgeons, and neuro-ICU nurses use it serially at the bedside to track a comatose or critically ill patient's trajectory and detect deterioration early.