What are neuro checks?

Updated: 4/28/2022
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14y ago

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Neuro checks are an assessment made by a medical professional on someone with a head injury, cervical injury, nerve function in injury/surgery, or stroke. Neuro checks should be performed once an hour for 24 hours in someone with a head injury. Depending on type of injury any of these checks could be done:

  • Level of Consciousness
  • A/O and compare it with their baseline
  • Speech clarity
  • Facial symmetry (smile)
  • Tongue midline (stick your tongue out; doesn't deviate to one side)
  • Grasp strength
  • Have the patient lift their leg up as you try to push it down; compare bilaterally
  • Pupil check (PERRLA: pupils equal, round, react to light and accommodation
Neuro checks can be done by someone other than a medical professional in cases of minor head injuries. These assessments should be followed every hour for 24 hours:
  • Make sure the person can be awakened
  • Make sure the person can walk
  • Make sure the person can speak normally
  • Make sure the person can move extremities normally
Seek medical attention right away if any of these symptoms are present:
  • Poor mental alertness
  • Abnormal walking
  • Abnormal balance
  • Abnormal behavior
  • Abnormal pupils
  • Abnormal speech
  • Abnormal thinking
  • Decreased strength in the arms and legs
  • Repeated vomiting
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It's not so much that a patient who has suffered a head injury cannot sleep, it's that depending on the injury, neurological tests need to be done. In the nursing world, we call them "neuro checks" and involve the patient answering questions. We need to determine if the patient is oriented to person (who they are), place (where they are, such as specific hospital, person's home, etc.) and time (the month, day and year). Since obviously this is harder with young children who are either not verbal or may not know the answers, we awaken them frequently and make sure they give age-appropriate answers, and are not too "sleepy" to awaken fully and maybe eat or interact with mom and dad. Neuro checks also involve observing the pupils for being reactive to light, and several other types of tests that involve neurological reactions. The length of time neuro checks go on for depends on the type and mechanism of injury, and if any of the neuro checks come back abnormal.

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