How do you assess a comatose patient?
Table of Contents
How do you assess a comatose patient?
The key components of the neurological examination of the comatose patient are:
- level of consciousness (Glasgow Coma Score — list the components; e.g. E4V5M6 = GCS 15)
- the pattern of breathing.
- size and reactivity of the pupils.
- eye movements and oculovestibular responses.
- motor responses (tone, reflexes and posturing)
How do you assess cranial nerves on a comatose patient?
Cranial nerve V may be tested in the comatose patient with the corneal reflex test. Cranial nerve VII may be examined by observing facial grimicing in response to a noxious stimulus. Cranial nerves IX an X may be evaluated with the gag reflex.
What are physical assessment techniques?
WHEN YOU PERFORM a physical assessment, you’ll use four techniques: inspection, palpation, percussion, and auscultation. Use them in sequence—unless you’re performing an abdominal assessment. Palpation and percussion can alter bowel sounds, so you’d inspect, auscultate, percuss, then palpate an abdomen.
What is the first thing to be examined in unconscious patient due to accident?
The initial step in the evaluation of an unconscious patient is to evaluate for the basic signs of life. The American Heart Association recommends examining for a pulse, followed by assessing airway patency and breathing pattern.
Do pupils react in coma?
All cranial nerve or brain stem reflexes must be absent without any spontaneous respirations. The pupils do not react to light and the corneal, oculocephalic (doll’s eyes), oculovestibular (cold caloric) and gag reflexes are absent.
Do comatose patients have reflexes?
During a coma, a person does not react to external stimuli, and they will not show normal reflex responses. People in a coma do not have sleep-wake cycles. Reasons for a coma include drug or alcohol intoxication, central nervous system disease, infections, and a stroke.
What is the management of unconscious patient?
Check the person’s airway, breathing, and circulation. If you do not think there is a spinal injury, put the person in the recovery position: Position the person lying face up. Turn the person’s face toward you. Take the person’s arm that is closest to you, and place it to his/her side, tucking it under the buttock.
What is the nursing management of unconscious patient?
Care of Unconscious Patient Maintaining patient’s airway. Protecting the patient from falling off the bed. Maintaining fluid balance and managing nutritional needs. Maintaining skin integrity. Preventing urinary retention.
What do unresponsive pupils mean?
– Non-reactive pupils may also be caused by local damage; – One dilated or fixed pupil may indicate an expanding/developing intracranial lesion, compressing the oculomotor nerve on the same side of the brain as the affected pupil.
What do blown pupils indicate?
Doctors sometimes refer to more pronounced mydriasis, when the pupils are fixed and dilated, as “blown pupil.” This condition can be a symptom of an injury to the brain from physical trauma or a stroke. The opposite of mydriasis is called miosis and is when the iris constricts to cause very small or pinpoint pupils.
How do you do a neurological examination?
These tests may include one or more of the following:
- Blood and/or urine tests.
- Imaging tests such as an x-ray or MRI.
- A cerebrospinal fluid (CSF) test.
- Biopsy.
- Tests, such as electroencephalography (EEG) and electromyography (EMG), which use small electric sensors to measure brain activity and nerve function.
What do we use to examine neurological patient?
A neurological examination assesses motor and sensory skills, hearing and speech, vision, coordination, and balance. It may also test mental status, mood, and behavior. The examination uses tools such as a tuning fork, flashlight, reflex hammer, and a tool for examining the eye.
What are the steps in a physical examination?
The components of a physical exam include:
- Inspection. Your examiner will look at, or “inspect” specific areas of your body for normal color, shape and consistency.
- Palpation.
- Percussion.
- Auscultation.
- The Neurologic Examination:
