Can you guys tell I have a Neuro test coming up that is either going to make or break me???
1) If you are assesing a comatose Pt, who is a 1 on the Glasgow chart for Eye response, do you open the lid and check the pupil response or not? If yes, is this how u would chart it....Glasgow Eye 1, pupils Pearl...or...if they don't react...Glasgow eye 1, pupils not PERLA? Or maybe u don't even open the eye?
2) How do u chart that u did a Glasgow? Do u write out each test, i.e., Eye 2, Speech 2, Motor 2. Hmmm.
3) What Pt's absolutely can't have a spinal tap?
4) If someone comes into the ER with a suspected neck and/or spinal cord injury, and they have a brace on, the HOB is to be up 30 degrees, right? The only time they are to be flat is if they aren't stabilized, but if they are, the HOB should be up, for both types of injuries?
Mar 21, '05
Yes! You're absolutely correct about wanting to rid the pt. of excess fluid in skull. Now,to monitor ICP, drain fluid if need be, collect a CSF sample and administer meds (be sure they're preservative free) they do a vertriculostomy. It is a form of invasive monitoring that also has a closed CSF drainage system attached. As far as CVA patients go, they are not usually at risk for increased ICP. I'm still digging for the "why" for not doing the lunbar puncture for a patient, but I figured I'd put this up for now.
Last edit by NurseyBaby'05 on Mar 21, '05