Neurological observations

Trauma to the brain from injury or illness can cause sustained, raised intracranial pressure. In such patients, neurological observations are a fundamental aspect of nursing care and the ability to make and record such observations accurately is an essential nursing skill. Neurological observations are a collection of information on the function and integrity of a patient's central nervous system—the brain and and spinal cord. This article will discuss the tools used in their observation, including the Glasgow coma scale tool, pupillary response, and limb power observations, and provide a ‘how-to’ guide on neurological observations.

Neurological observations are the collection of information that indicate the function and integrity of a patient's central nervous system (brain and spinal cord). Neurological observations should only be performed by appropriately competent staff and must be recorded accurately (National Institute for Health and Care Excellence (NICE), 2017). The frequency of neurological observations will be dictated by the condition of the patient and reviewed regularly by a registered practitioner (NICE, 2017). Their professional knowledge and judgement, and following NICE guidance, will prescribe the frequency of this assessment, which can be as regular as every 15 minutes, depending on the patient's clinical condition. Any neurological deterioration must be reported promptly as the sooner changes are recognised, the less chance of permanent secondary damage to the brain.

Brain pressure

Intracranial pressure is determined by the pressure inside the skull and on brain tissue. The cranium is made up of brain matter, blood and

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