Cristagali

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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
 

kasimagore1

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May 15, 2002
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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.