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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

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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: