Published Jun 1, 2005
joyful nurse
26 Posts
We have just started doing neurosurgery in our mixed ICU/CCU. Our current documentation flow sheet only has the Glascow Coma scale on it. Would any of you be willing to share a neuro assesment form that has worked for you?
RoxanRN
388 Posts
Roxan, RN
Neuro Critical Care
bellehill, RN
566 Posts
The neuro assessment section of our flowsheet includes the GCS (with the motor responses further divided by extremity - each extremity gets a number) and pupil size/reaction. However, this is the same flowsheet used in all the ICUs.Roxan, RNNeuro Critical Care
Ours also has a section for cough/corneal/gag/swallow assessment along with a pronator drift check. Our flowsheet is also used in every ICU.
gwenith, BSN, RN
3,755 Posts
There are a lot of other neuro assessment forms besides the Glascow coma scale and when I find what I have done with the assignment I wrote I will post some articles for you to evaluate.
Trouble is that the GCS is the most researched of all the scales - however I do beleive we have become fixated upon it and we certainly need an adequate adaptation for ventilated patients!!
Found a couple of good assessment sites - this one incorporates a link to the stroke assessment scale
http://rnweb.com/rnweb/article/articleDetail.jsp?id=120796
suzy253, RN
3,815 Posts
Just stumbled across this timely post. Thanks Gwenith. I'll be starting neuro in my upcoming senior year. Cheers
jess1023rn
3 Posts
Orientation
GCS
All cranial nerves (L+R)
reflexes
Any drains? Amount and color of CSF
Proprioception
sosand
facial symmetry
EOM
orientation
icucu777
1 Post
Could you send me your flow sheet. I am taking a nurse refresher and studying neuro now. Gloria