Now with sensation, you'll want
a really accurate assessment.
So the patient has to be awake and
has to be able to talk to you
and tell you whether they can feel the
sensation and if it's equal on both sides.
Getting the pattern there?
Equal on both sides, equal on
both sides, equal on both sides.
So for whatever we're assessing,
if it involves both sides,
we're comparing those sides
to see what's different.
Because oftentimes, when
people have an injury -
a stroke, spinal cord injury or head injury,
one side may be impaired more than the other.
Another thing with neuro patients,
many can change throughout your shift.
You'll see things shift and change alll the time.
Not every neuro assessment in the same patient
in the same shift is exactly the same.
That's what kind of cool about the neuro patients
because there's something always going on.
Now here's how I recommend you assess sensation.
We're looking for them to understand the difference
between light touch with your fingertips first.
So you start with the patient's feet
and gently move up the body to the face,
asking the patient if they can feel that
sensation on both sides of the body.
Now we'll talk about superficial pain sensations, so
this is not, nailbeds or (grunt), sternum, this
is looking at with a sharp object, not a needle.
But a relatively sharp object
and a relatively dull object.
Now sometimes think of it like a
relatively sharp object like a toothpick.
That's as sharp as I'm talking.
You might even use the end
of a wooden cotton swab.
You can use that on the bottom of their feet
and then use the cotton tip part to see whether
they can try something with a dull object.
The idea is, there needs to be a difference
between the sharp object and the dull object.
There's a little piece of wire that
you can use for each patient
to kinda touch the bottom of their feet
and move that way up, but the concept is,
you need a diference between the sharper object and
the duller object that you can tell the difference,
that way your patient, see
that's a good way to test them.
If you can tell the difference in the objects that
you're using, then it's a fair test for your patient.
Now this word always gets me.
Okay, so test proprioception, okay
I'm not that good in the gym but
I'm working with a trainor,
I always have a hard time with this, so I don't know
how I would actually do on a neuro assessment.
But this is a lot simpler.
We're just looking for them to have a
feel where the position of their body is.
So what you wanna do is to move the
patient's toes and fingers up or down.
So you don't want them looking at it because
I don't want them looking at it and know.
You want it out of their line of vision
You grasp their fingers or their toes and
you move it up or down or side to side
and have the patient tell if they can
tell if it's up down or side to side.
okay, that's how you test proprioception.
I did it, two times in a row.
I'm, not trying it the third time,
I don't wanna push my luck.