FOUR Score (ICU coma scale for intubated patients)
FOUR (Full Outline of UnResponsiveness) Score (Wijdicks 2005): eye response, motor response, brainstem reflexes, and respiration each 0-4; total 0-16 with the per-component E/M/B/R breakdown reported.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Eye response
- 4
- Motor response
- 4
- Brainstem reflexes
- 4
- Respiration
- 4
Result: FOUR Score 16 of 16 per Wijdicks 2005. All four components maximal (E4 M4 B4 R4).
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 16
- All four components maximal; no observed coma signs on FOUR.
- 1-15
- Intermediate pattern; report the per-component E/M/B/R values for the bedside hand-off.
- 0
- All four components absent - consistent with very poor prognosis; the FOUR=0 pattern is part of the AAN 2010 brain-death determination workup as a screen for confounders.
What you enter
- Eye response (0-4)
- Motor response (0-4)
- Brainstem reflexes (0-4)
- Respiration (0-4)
How this is calculated
Wijdicks EFM, Bamlet WR, Maramattom BV, Manno EM, McClelland RL. Validation of a new coma scale: The FOUR score. Ann Neurol. 2005;58(4):585-593. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.