A practical approach to neurologic evaluation in the intensive care unit

Abstract Delirium and neurologic impairment are extremely common in the intensive care setting, and their delayed identification is an important contributor to patient morbidity. Even in comatose patients, the clinical neurologic examination remains the most accurate and effective tool in assessing...

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Bibliographic Details
Published in:Journal of critical care 2014-08, Vol.29 (4), p.627-633
Main Authors: Singhal, Neel S., MD, PhD, Josephson, S. Andrew, MD
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Arousal
Brain Diseases - complications
Brain Diseases - diagnosis
Coma
Coma - etiology
Confusion - diagnosis
Confusion - etiology
Consciousness
Cough
Critical Care
Critical Illness
Delirium
Delirium - etiology
Encephalopathy
Female
Gagging - physiology
Humans
Hypertension
Hypnotics and Sedatives - administration & dosage
Intensive care
Intensive Care Units
Male
Middle Aged
Mortality
Nervous system
Neurologic Examination - methods
Neurological examination
Neurology
Psychomotor Performance - physiology
Reflex, Pupillary - physiology
Respiration
Stroke
Ventilation
Withholding Treatment
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Summary:Abstract Delirium and neurologic impairment are extremely common in the intensive care setting, and their delayed identification is an important contributor to patient morbidity. Even in comatose patients, the clinical neurologic examination remains the most accurate and effective tool in assessing nervous system function. Rapid identification of neurologic deficits with a practical and easily reproducible neurologic examination is a core skill for effectively caring for critically ill patients. The purpose of this tutorial is to discuss techniques of neurologic examination and localization with an emphasis on comatose patients. Commonly encountered cases of encephalopathy and coma along with clinical pearls are presented.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2014.02.014