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British medical acronym standing for Alert, Voice, Pain, Unresponsive. It is used in casualty assessment where Alert means just that, the patient is alert and responsive. Voice means that although dazed or semi-conscious, the patient responds to the sound of the human voice. Pain that although apparently unconscious the patient responds to a pain stimulus. Unresponsive means that the patient is unconscious and unresponsive or worse.

With the increase people suffering from the effects of overindulgence of alcohol turning up at Accident and Emergency departments the acronym has changed slightly to reflect the behaviour of these people. Namely Acrimonious, Vomiting, Peeing/Pissing, Unconscious. In these particular cases Acrimonious means aggressive and quarrelsome, Vomiting means suffering from nausea or actually vomiting, Peeing/Pissing means that they have lost control of their bladder and possibly bowels as well and Unconscious that they are out cold either sleeping it off or dying from alcohol poisoning.

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