Pupils in head injuries

[bdoss2006]

Why do you assess peoples pupils with possible head injuries that are fully alert and oriented? Correct me if I’m wrong, but if you have a bad enough head injury/increased ICP, wouldn’t there be more signs and symptoms? Is it just being extra thorough?

 

[NomadicMedic]

This might help. https://openoregon.pressbooks.pub/emslabmanual/chapter/pupil-assessment/#:~:text=The pupil assessment may reveal,cause pupils to become dilated.

This too. https://uniontestprep.com/emt-test/resources/checking-the-pupils-during-patient-assessment

 

[E tank]

Why do you assess peoples pupils with possible head injuries that are fully alert and oriented? Correct me if I’m wrong, but if you have a bad enough head injury/increased ICP, wouldn’t there be more signs and symptoms? Is it just being extra thorough?

everyone should have their pupils examined in the physical exam, regardless of cc.

 

[CCCSD]

Did you not learn anything in your class? It’s a serious question. Just because you passed doesn’t mean you know, and that’s a scathing review of your program.

 

[MMiz]

I’m sure there are better answers but I do it to assess the patient’s neurological state.

If I notice sluggish response, unequal pupils, or unexpected pupil size, it’s a good hint that I need to do a more thorough medical exam.

 

[E tank]

Here's a really good review that everyone at any level should read:

Anisocoria - StatPearls - NCBI Bookshelf

 

[Akulahawk]

Simply put, it's a window into the state of the brain... and noting changes in the pupils can be as, or more, important than a single assessment in the setting of head injury.

 

[EpiEMS]

Here's a really good review that everyone at any level should read:

Anisocoria - StatPearls - NCBI Bookshelf

Love stat pearls!

 

[bdoss2006]

Did you not learn anything in your class? It’s a serious question. Just because you passed doesn’t mean you know, and that’s a scathing review of your program.

Yes, I learned plenty in my class. I wish you would just leave this forum. **CL edit ** I’m concerned about how you treat your patients emotionally, because I’d say you are just as rude and disrespectful in person as on here.

 

[bdoss2006]

I probably worded the question wrong. I get why you assess it, but it's more the physiological part I don't understand. If there’s enough head trauma to cause pupil changes, wouldn’t there be other signs? (Decreased LOC, confusion, etc.)

 

[luke_31]

Yes, I learned plenty in my class. I wish you would just leave this forum. You are a total jerk. I’m concerned about how you treat your patients emotionally, because I’d say you are just as rude and disrespectful in person as on here.

Young man that is not a good way to get information that you want or to interact well on any forums you may join. Keep in mind you’re very, very new to this profession and have been having people with a heck of a lot longer experience than you, telling you things you don’t want to hear. Lots of us commenting to you have been in the field for quite a while and have been FTOs, supervisors, some on this forum are also RNs or doctors. But good luck in your endeavors and feel free to leave if you don’t like the answers you’re getting here.

 

[CCCSD]

Yes, I learned plenty in my class. I wish you would just leave this forum. You are a total jerk. I’m concerned about how you treat your patients emotionally, because I’d say you are just as rude and disrespectful in person as on here.

40+ years in and never a complaint. I’m an Instructor and expect quality and ability. My patients get the same treatment as I would provide my Grandmother.

 

[luke_31]

40+ years in and never a complaint. I’m an Instructor and expect quality and ability. My patients get the same treatment as I would provide my Grandmother.

I’m honestly beginning to wonder if we shouldn’t just lock his account so he can’t post anymore. We’ve tried being nice and then firm but he just doesn’t get it.

 

[DrParasite]

Yes, I learned plenty in my class. I wish you would just leave this forum. You are a total jerk. I’m concerned about how you treat your patients emotionally, because I’d say you are just as rude and disrespectful in person as on here.

@CCCSD can be a jerk... he and I have disagreed on many topics. But, in this case, he's not wrong. Many of the questions you are asking are basic questions, ones that should have been answered in your class. In fact, based on the questions you are asking, I'd want him to treat my family instead of you, because you don't seem to have a basic understanding of fundamental topics.

I get why you assess it, but it's more the physiological part I don't understand. If there’s enough head trauma to cause pupil changes, wouldn’t there be other signs? (Decreased LOC, confusion, etc.)

Maybe, maybe not... Let me ask you this question: you are called to a nursing home for an elderly patient who fell, with a hx of dementia. when you assess her, you find her left pupil is huge, and her right one is normal... is this patient sick, and needs rapid transport to a hospital, or do you think her pupils are irrelevant?

 

[bdoss2006]

@CCCSD can be a jerk... he and I have disagreed on many topics. But, in this case, he's not wrong. Many of the questions you are asking are basic questions, ones that should have been answered in your class. In fact, based on the questions you are asking, I'd want him to treat my family instead of you, because you don't seem to have a basic understanding of fundamental topics.

Maybe, maybe not... Let me ask you this question: you are called to a nursing home for an elderly patient who fell, with a hx of dementia. when you assess her, you find her left pupil is huge, and her right one is normal... is this patient sick, and needs rapid transport to a hospital, or do you think her pupils are irrelevant?

I do have a basic understanding of fundamental topics. As I have stated, I think with a lot of my questions, I know the answers, but I just am paranoid that I’m wrong, so I ask people smarter than me if I’m correct. These said people only respond with negative comments implying I’m too stupid to do the job.

 

[mgr22]

...As I have stated, I think with a lot of my questions, I know the answers, but I just am paranoid that I’m wrong, so I ask people smarter than me if I’m correct. These said people only respond with negative comments implying I’m too stupid to do the job.

Sounds like something to work on -- the paranoid part, at least. Maybe the comments aren't as negative as you think.

 

[bdoss2006]

Sounds like something to work on -- the paranoid part, at least. Maybe the comments aren't as negative as you think.

I don’t see how it’s that bad of a thing. It’s just making sure I am 100% correct to make sure my patients have appropriate care. Maybe a little extreme but not a bad thing.

 

[ffemt8978]

This one is done too