Neuro checks
Formal Definition
Standardized serial neurological assessments performed at defined intervals (e.g., every 1–4 hours) on at-risk patients, typically including level of consciousness (GCS or AVPU), pupil size and reactivity, orientation, focal deficits, and vital signs; used to detect early neurological deterioration.
How It's Used on the Ward
"Q1 neuro checks" or "put them on neuro checks" — a nursing-driven monitoring order for any patient at risk for sudden neurological decline.
Example
""Post-craniotomy patient on Q1 neuro checks: any new focal deficit, change in pupils, or GCS drop of 2 points gets an immediate call to the team. That's how you catch a re-bleed before it's too late.""
Clinical Context
Common indications: traumatic brain injury, post-neurosurgery, subarachnoid hemorrhage, large ischemic stroke, epidural/subdural hematoma, meningitis, hepatic encephalopathy with rapid change. The AVPU scale (Alert, Voice, Pain, Unresponsive) is faster than GCS in rapid assessment. Pupils: unilateral fixed and dilated = herniation until proven otherwise — call immediately. Bilateral pinpoint pupils = opioid toxicity or pontine lesion. Serial neuro checks are only as good as the person performing them — teach nurses what changes to flag.