To apply painful stimuli, start with the least noxiousirritation or pressure and proceed to more painful stimulation if the client dose not respond. Begin each phase of the assessment by speaking in a normal voice; if no response is obtained use a loud voice if the client dose not response is obtained, use a loud viice. If theclient dose not respon, gently shake him or her. The shaking should be similar to that used in attempting to wake up a child. If that is unsuccessful, painful stimuli aer applied using one of the following methods