Conscious but may appear groggy, disoriented,
and may have trouble with balance and gait.

Varying levels of consciousness, disoriented,
generally unaware as to what has happened to
them. May have other injuries including broken bones and soft tissue injury.

Present as unconscious, perhaps combative, and
non-responsive. This can be a life threatening
injury.

Level I: 

No response to pain, sound, or sight.

Level II:

Generalized response regardless of the type or location of stimuli.

Level III:

Localized response. Blinks to strong light, turns toward/away from sound, responds to physical discomfort, inconsistent response to commands..

Level IV:

Confused/agitated. Alert, very active, aggressive or bizarre behaviors, non-purposeful motor movement, short attention span, inappropriate verbalization.

Level V:

Confused/inappropriate/non-agitated. Gross attention to environment, distractible, requires continual redirection, agitated by too much stimuli, inappropriate social interactions.

Level VI:

Confused/appropriate. Inconsistent orientation, recent memory and attention impaired, follows simple directions, goal directed with assistance, begins to recall past. Emerging awareness of self.

Level VII:

Automatic/appropriate. Performs daily routines in robot-like manner, skills deteriorate in unfamiliar environments, unrealistic planning. Superficial awareness.

Level VIII:

Purposeful/appropriate. Stand-by assist. Uses memory device with intermittent assist, over or under estimates abilities, irritable, self-centered, acknowledges other’s feelings with minimal assist, low frustration tolerance, carries out familiar tasks with intermittent assist.

Level IX: 

Purposeful/appropriate. Stand-by assist on request. Complete familiar tasks independently, independently shifts between tasks, self-monitors and anticipates problems with stand-by assist, uses assistive memory devices to recall schedule.

Level X:

Purposeful/appropriate. Modified independence. Handles multiple tasks simultaneously, independently initiates and carries out unfamiliar routines, anticipates impact of impairments, independently thinks about consequences of decisions, social interaction is consistently appropriate.