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Rancho Levels

from NBCOT Review & Study Guide, 6th ed. pg. 167-168

Level I - No Response Complete absence of observable change in behavior when presented visual, auditory, tactile, proprioceptive, vestibular & pain stimuli
Level II - Generalized Response - reflex response to painful stimuli - responds to repeated auditory stimuli w/ increased/decreased activity - responds to ext. stimuli w/ gross body mvmts and/or not purposeful vocalization - responses may be significantly delayed
Level III - Localized Response - withdrawal or vocalization to painful stimuli - turns toward/away from auditory stimuli - blinks when strong light crosses visual field - responds to discomfort by pulling tubes/restraints - may respond to family/friends, not to others
Level IV - Confused/Agitated - alert, heightened state of activity - unable to cooperate w/ tx. efforts - absent ST memory - purposeful attempts to remove tubes, get out of bed - may exhibit aggressive or flight behavior - motor activities (sitting, reaching) w/out apparent purp
Level V - Confused, Inappropriate Non-Agitated - alert, non-agitated, may wander randomly - not oriented to person, place, or time - unable to learn new info - frequent, brief periods of non-purposeful sustained attention - absent goal-directed, problem solving, self-monitored behavior
Level VI - Confused, Appropriate - inconsistently oriented to person, time, place - able to attend to highly familiar tasks in non-distracting environment - remote memory has more dept and detail than recent memory - Mod A to problem solve - supervised for old learning, (self-care)
Level VII - Automatic, Appropriate - oriented to person, place in familiar enviro, Mod A for orientation to time - Attend to highly fam. tasks in 30 min - overestimates abilities - doesn't recognize inappropriate social interactions - Superficially aware of condition, not impairments
Level VIII - Purposeful, Appropriate - consistently oriented: person, place, time - I attends/completes familiar tasks in 1 hr. - recalls/integrates past & recent events - overestimates abilities - irritable, depressed, argumentative, self-centered - Aware/acknowledges impairments
Level I No Response
Level II Generalized response
Level III Localized response
Level IV Confused/Agitated
Level V Confused, Inappropriate - Non-Agigtated
Level VI Confused, Appropriate
Level VII Automatic, Appropriate
Level VIII Purposeful, Appropriate
Created by: msmaus
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