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NEUROLOGICAL

— – –
NEUROLOGICAL

M.R.N.
SURNAME ………………………………………………………… � D.0.6………………………………. .
SEX
OTHER
NAMES ………………………………………………………………………………

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OBSERVIONS
FACILIT: ____ _ __
General Instructions

C
1
(
f
C
E
0
0
3
0
C
u
C
a
·a
:c
Verbal
Response Confused 4
Inappropriate words 3
Record ‘D’ if dysphaslc Incomprehensible sounds 2
‘T’ if intubated
No verbal response 1
Best Obeys commands 6
Motor
Response Localising pain 5
Withdrawal from pain 4
See reverse for Abnormal flexion to pain 3
to guidance determine on how best Abnormal extension to pain 2
motor response
No motor response 1
Total Score
R Record reaction to light as
Size (mm)
‘+’ if normal Reaction
‘S’ if sluggish Reaction
L ‘-‘ ‘C’ifIfnone eye closed by swelling
Size (mm)
. .
. .
.
.
. .
.
.
Date
Time
24/3 25/3 03
00
04
00
05
00
06
00
07
00
23
25
24
00
00
30
01
00
02
00
. . . . . . . . .
4
4
+
+
4 4
4 4
+ +
+ +
4 4 4
4 4 4
+ + +
+ + +
5+4+
5+4+
4+4+

C
E
C
0

.
E
1. Each time a set of neurological observations are recorded; a complete set of vital signs (RR,
Sp0 , BP HR, T°, Consciousness) should be completed and recorded on the ADDS
observation chart
Best Eyes open spontaneously 4
Eye
Response Eye opening to verbal stimuli 3
Record ‘C’ if no response Eye opening to pain 2
possibly due to bilateral
periorbital swelling No eye opening 1
Best Orientated 5
1 2 3 4 5 6 7
Pupil scale
(mm) • • • • • e •
Normal power
Mild weakness
Severe weakness
Arms
Spastic flexion
Extension
Record findings for None
RIGHT (‘R’) and LEFT (‘L’)
separately if different Normal power
Mild weakness
Legs Severe weakness
Extension
I None
(Adopted from Wiese, M, UHL, Patient Safety First, WHS, UK)
8

z
m
C
:
0
r
0
C

0
)
r
0
C
e
m
:
;-
0
z
e
1(
. . . . . .
. . . . . .
. . . . . .
Short stay
. .
. . .
. . .

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