The patient's mental status and neurologic function should be assessed once the ABCs have been completed and any identifiable life threats have been addressed. The mental status can be assessed quickly using the AVPU scale. In this scale, the patient is determined to be alert, responsive only to verbal stimuli, responsive only to painful stimuli or unresponsive. A gross evaluation of strength and sensation can be conducted by asking the patient to wiggle their fingers and toes or squeeze your hand and testing their ability to feel you touching each of their four extremities. This examination is not a thorough neurologic evaluation so, if the patient is suspected of a possible spine or spinal cord injury, immobilization should be performed. Any patient who has an altered mental status or is unresponsive, should be immediately transported and the more in-depth assessment of the brain function can be performed using the Glasgow Coma Scale, or GCS. Any patient with abnormal neurologic exam or suspected of having a spine injury should be immobilzed.