The neurologic assessment toolbox: Key assessments at critical times
Janice Mink BSN, RN, CCRN, CNRN

$7.95 		Nursing2013 Critical Care
May 2012 
Volume 7  Number 3
Pages 12 - 17
 
  PDF Version Available!

ABSTRACT
Critical care nurses have come to rely on certain standardized tools to aid in patient assessment. However, in neurologic care, patient assessment often depends on type of health problems the patient is experiencing. This article reviews five alterations in neurologic function often encountered in critical care, the standardized neurologic assessments routinely used for these problems, and what these neurologic assessments actually tell you about your patient's neurologic function.Standardized neurologic assessments have been developed over the last 30 years to more accurately and consistently define patient status and to facilitate communication about a patient's condition. This article focuses on the Glasgow Coma Scale (GCS), National Institutes of Health Stroke Scale (NIHSS), International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), Mini-Cog Assessment Instrument for Dementia, and the Confusion Assessment Method for the ICU (CAM-ICU).Keep in mind these key points when you perform any neurologic assessment: The assessment often helps to identify the location of the neurologic problem. To perfect your skill, seek out information on how to perform the assessment correctly. Observe expert practitioners performing the assessment. Practice the assessment first on a healthy volunteer and use the assessment every time you think the assessment will give you information about a patient. Communicate your findings to the patient's healthcare provider, and objectively document them.Always perform the standardized assessment and score the patient's response as described in the assessment instructions. This is essential to obtaining accurate information about the patient's condition. Identify external forces (such as medications, other injuries, or altered lab values) that may affect the patient's responses during the assessment.Every assessment tool defines a normal baseline of neurologic functioning. Abnormalities that existed before the patient's

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