Neurological observations are an important part of the patient assessment. Neurological observations assess an individual's level of consciousness, pupil size and response, blood pressure and limb movement. It is important to be aware that some patient's will have premorbid neurological symptoms or deficit such as those who have had a previous stroke or brain injury or those living with dementia. when recording the neurological observations it is vital that these findings are still recorded on the Neurological Observation Chart but that it is documented in the notes what the patient's normal baseline is. Importantly it may be a the trend in the observations or changes from initial findings which will influence the treatment.
As well as the Neurological Observations there are other tests which may show a neurological deficit. These include the FAST test and a Cranial Nerve Exam.
Read the illustrated guide to Neurological Observations on ClinicalSkills.net here:
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Watch this space quiz coming soon. Until then use the neurological observation chart below and go through each exam and observation and test your knowledge, what do you do for each of the sections?
Click on the button below to access the paper version of this, which you can open here (and print if required):
Waterhouse, C. (2005). The Glasgow Coma Scale and other neurological observations. Nursing Standard (through 2013), 19(33), 56-64; quiz 66-7. Retrieved from https://hallam.idm.oclc.org/login?url=https://www-proquest-com.hallam.idm.oclc.org/scholarly-journals/glasgow-coma-scale-other-neurological/docview/219837362/se-2?accountid=13827
Royal Marsden Manual of Clinical Procedures (9th Edition):Neurological Observations- Page 521- 534
Example of neurological observation chart from practice. This chart shows an example of a chart that allows for neurological examination that requires consent, cognitive ability and co operation. It also shows a group of neurological observations that can be completed in conversation and by observing the patient therefore does not require consent, cognitive ability or co operation. This can be particularly important in situations of fall or new head injury when neurological observations are vital, but the patient cannot or does not allow for the examination to take place.
RELEVENT NICE GUIDENCE
Date reviewed:
Next review: August 2023