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PICU Quick Reference Pediatric Neurological Assessment. Infant or Severe Developmental Delay. Child. Adolescent. Goal : Recognize/Report subtle changes in baseline neurological status before deterioration. Most Important: Be systematic! Repeat assessment same order each time:
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PICU Quick Reference Pediatric Neurological Assessment Infant or Severe Developmental Delay Child Adolescent
Goal : Recognize/Report subtle changes in baseline neurological status before deterioration. • Most Important: Be systematic! Repeat assessment same order each time: • Appearance and Observation • Level of consciousness • Cranial Nerve Assessment • Motor Sensory Function • Vital Signs • External Monitoring Devices Exam - • Infant/Toddler- determine eye opening, arousability, level or irritability/consolability, symmetry of • facial expressions and movement of upper and lower extremities, listen for increase weakness • or pitch in cry/vocalizations, assess anterior fontanel, check each pupil separately for size , shape, • equality of reaction to light, check ability to track object, note muscle tone for rigid extension or • flexion of extremities, flaccidity and/or unusual posturing. • Child- (In addition )- note c/o headache, assess social orientation attention span, orientation in • terms of memory (name of favorite stuffed animal etc.) degree of agitation/ restlessness, clarity • of speech, EOMs, visual acuity, blow fish cheeks, tongue deviation, symmetrical shoulder shrug, • high five, drift assessment*, grip strength, ability to lift legs against resistance. • Adolescent- (In addition)-note complaints of double vision, dizziness, anxiety, fearfulness Score patient using Glascow Coma scale: