ICU nurses: Do you check cornea reflex and gag reflex q4h ? - Page 2Register Today!
- Jul 12, '12 by nursenotamaidUnless that patient is talking to me, yes, I do check, however, on our neuro's - we check q1h.
- Jul 16, '12 by Esme12Quote from chk 23What is your definition of accommodation to light. It is not only the ability to focus far and near....it can also be tested when you flash the light in one pupil and the opposite pupil responds as well....equally.The PERRLA is a pet peeve of mine. I find it interesting working in the ICU where patients are comatose and barely respond to anything, somehow are able to follow commands to test accommodation.
- Jul 16, '12 by turnforthenurseRNQuote from ckh23I agree. I had a patient who came from ICU and within two hours got shipped back to ICU because they coded on my floor...when I finally had a chance to document my assessment leading up to calling RR and a code blue, I saw the RN accepting the patient documented "PERRLA at 3mm" when in reality, the pupils were more like 5mm and non-reactive." The RN then changed their assessment once I put mine in.The PERRLA is a pet peeve of mine. I find it interesting working in the ICU where patients are comatose and barely respond to anything, somehow are able to follow commands to test accommodation.
- Jul 30 by blondesareeasyHAVE to check or NEED to check? There ain't no stone etchings here.
- Oct 8 by JarreuxThat's the consensual light reflex. Accommodation is the narrowing or widening of the pupil to accommodate focusing near and far respectively. I just say PERRL unless I actually assessed for accommodation.
Cough/gag/pupils are assessed and charted Q15,30min,1,2,4hrs as ordered. I only check gag when appropriate (during oral care on vented pts, etc), or otherwise chart deferred. I first check lids when checking pupils by moving my other hand towards their eyes fast enough to illicit the reflex, and then progress by least invasive first as noted above. I only have to chart that once then chart 'no changes to prior assessment' and typically don't formally check it again unless there has been a change in the pt's condition.Last edit by Jarreux on Oct 8
- Oct 13 by Nurse_Anytime there's a neurological impairment, we usually check every hour.