student MICU rotation

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Cristagali

Senior Member
7+ Year Member
15+ Year Member
20+ Year Member
Joined
Jun 9, 2003
Messages
219
Reaction score
2
Hey guys, need some advice. How do I do a QUICK assessment of neuro on an intubated patient in the MICU? (These are Med patients NOT neuro ICU.) How should I say this in my presentation? sorry, thanks :D

Members don't see this ad.
 
If pt. is sedated or paralyzed for intubation, simply stating so. Neurological exam probably not so accurate in a sedated or paralyzed pt. If suspect for underlying neurological deficit not due to medical sedation, you should record Coma scale and check corneal (CN 5+7), pupillary-direct and consensual (2+3), Gag (9+10), noxious stimulation (5+7), jaw jerk (5+5), oculocephalic (3,4,6,8) response. Then check pain localization+/- posturing. Remark on motor tone and DTR including babinski sign. This should be enough for an initial assessment. Your day to day assessment may vary depends on how detail oriented are your upper level and attending. In an experienced person, these exams could be done relatively quick (in 2-3 minutes). Neuro presentation usually goes in the following order: Mental status, CN, Motor, Sensory, Coordination, DTR, and posture/gait in an awake, non-intubated or sedated person.
 
Very nice post. Thank you
 
Top