3-3-25 lecture

Placement Schedule

Placement Dates:

• Group 1 starts on June 2, followed by June 9 and June 16.

• First group: approximately half the students go on first placement for three weeks.

• Students not on first placement attend class only on Thursdays.

• Complete AAP on the first Thursday.

• First exam on the second Thursday.

• Possible exam resit on the third Thursday.

• Following AAP, students who have completed it will access placement while others return for AAP.

• Week off on July 14, with semester two beginning on July 21.

• Adherence to Victorian school holidays.

• Note: Crossover with school holidays due to late Easter.

Neuro Observations

Importance of Neuro Observations:

• Assess neurological function, critical for patients with suspected injuries affecting the brain.

• Observations consist of monitoring physical responses post falls, unexplained confusion, or cognitive decline.

Hurdle Assessment Components

• The hurdle consists of three components:

  • Vital Signs: escalated last week.

  • Neuro Observations: focus of this week.

  • Neurovascular Assessment: to follow.

Goals of Neuro Observations

• To check for any changes in neurological status, especially after falls or unexplained symptoms.

• Essential in situations like unwitnessed falls where a patient’s history is unknown.

Assessment Procedures

Central Nervous System Functions:

• Motor Functions: Movement and coordination.

• Sensory Functions: External stimuli recognition (pain, touch).

• Autonomic Functions: Involuntary responses (heart rate, breathing).

Key Neuro Assessment Tools

• Level of Consciousness (LOC): Assessment criteria using Glasgow Coma Scale (GCS). Three elements: Eyes open (E), Verbal response (V), Motor response (M).

• Pupil Response: Checking size and reactivity to light (PERRL - Pupils Equal, Round, Reactive to Light).

• Limb Strength: Assessment through squeezing, pulling, and pushing.

Neurovascular Observations

Purpose and Procedure:

• Neurovascular observations evaluate both sensory and motor nerve functions alongside blood flow.

• Vascular Checks:

  • Color: assess for normal, pale, cyanotic, or mottled appearance.

  • Temperature: check if warm, cool, or cold.

  • Pulses: evaluate if strong, weak, or nonpalpable.

  • Capillary refill time: measure returning blood color.

• Neuro Checks:

  • Movement: assess movements of fingers/toes and wrist/ankles.

  • Sensation: evaluate ability to sense touch in pre-defined areas.

When to Perform Neuro Observations:

• After any incident: Perform observations immediately after any fall, unexplained confusion, or cognitive decline to establish a baseline and monitor for changes.

• Routine Assessments: Conduct at regular intervals (e.g., every hour, or more frequently in critical situations) for patients under observation.

• Post-surgery: Assess regularly after surgeries that may impact neurological function, typically every hour for the first few hours, then according to protocol.

• Changes in Condition: Whenever there is a noticeable change in a patient's condition or symptoms, even if not related to falls or known injuries.

Signs of Compartment Syndrome

• Compartment syndrome occurs when swelling in a limb increases pressure on nerves and blood vessels; must be identified early to prevent permanent damage.

• Symptoms: increased pain, tingling sensations, and diminished motor function.

• Management: immediate assessment and potential surgical intervention.

Patient Interaction and Communication

• Emphasize patient feedback regarding pain levels and functional changes during assessments.

• Explain the rationale behind regular checks to alleviate anxiety about health concerns.

Final Notes on Assessment Protocols

• Always follow prescribed protocols in assessments and charting.

• If changes or abnormalities arise, report immediately to ensure prompt medical intervention if necessary.

• Utilize charts consistently for accuracy in assessing and recording observations.

• Maintain communication with patients regarding expectations post-surgery or treatment, particularly about expected recovery timelines and sensations.