As others have said, in addition to the A&O questions, does their conversation make sense? Is it appropriate for the situation? Repetitive statements? Can the patient verbalize a coherent plan of self-care? Can the patient count backwards from 100 by 7's (serial 7's) or spell world backwards?Other than the AVPU/A and O times __ and checking pupils/tracking eyes
Also GCS and just asking them to do simple tasks.
Can they reiterate what's going on? If they can answer A&O questions but can't explain to me what's happening to them then they aren't awake alert and oriented.
Neuro exams are very in depth. As a basic, stick to what you know, IMO.
What are you talking about? Who said anything about "sucking"?
A basic has no need to do a full neuro exam. And I can't say I've heard of any basics being taught how to do a full neuro in school.
Wow, this is terrible advice. Most EMTs and even medics suck at neuro exams. When you suck at something, you should get better at it, no matter your cert level. Every full neuro exam should include the following:
GCS (includes A&Ox whatever)
CSM x 4
Cranial nerves (this is where it gets complex, but takes literally 10 seconds)
Stroke screen (for the most part a narrow cranial nerve exam)
Deep tendon reflexes (we don't do this and it's seldom important)
Ataxia? Tongue fasciculations?
There's a lot of research lately about quick cranial nerve adjustments and cerebellotonsillar strokes. Google HINTS cerebellotonsillar stroke if interested.
As for tracking eyes, you're testing 2 cranial nerves. Out of 12. If you track your pt's eyes upwards as well, that's 3 (CN3, 4, and 6). Can they see (CN2)? Smell (CN1)? Have a pt puff their cheeks (CN7, impaired in Bell's palsy), Wiggle their tongue from side to side (CN12), shrug their shoulders (CN11), test their ability to turn head from side to side without dizziness (vestibular branch of CN8). CN5 is sensory to the face. CN9 is mostly sensory except for motor to the muscle that lifts the larynx when you swallow.
Checking cranial nerves will increase your chance of catching strokes (although Cincinnati Stroke Scale is 90something% sensitive), and may also be beneficial in catching carious nerve palsies from infections or neurologic disorders. It's a lot of info, but I find it useful surprisingly frequently. THAT SAID, IT HARDLY EVER CHANGES MY TREATMENT.
You don't know the value of the information you don't know until you know it.
How many ambulances have reflex hammers? Sure, you can go the absolute ghetto route and use the stethoscope or karate chop, but it's not the best.Good info in your post about CN testing!
I'm curious though as to why you'd say that DTRs are seldom important and not done. In the case of an OB patient, they are an absolute must.
AVPU is the start of your Neuro assessment. Then you would go on to assessing the pupils, then throw in a good stroke scale assessment for good measure.
That's a really really limited neuro exam.