FCCS Neurological Assessment Flashcards

The Glasgow Coma Scale (GCS) assesses which three components?

Answer: Eye opening, verbal response, motor response

The GCS evaluates eye opening (1–4), verbal response (1–5), and motor response (1–6) for a maximum score of 15.

A GCS score of 8 or less indicates what clinical concern?

Answer: Inability to protect the airway — consider intubation

GCS ≤ 8 is associated with inability to maintain airway patency and loss of protective reflexes, typically necessitating intubation.

Which finding on neurological exam suggests herniation syndrome?

Answer: Unilateral dilated, fixed pupil with ipsilateral hemiparesis

Uncal herniation compresses CN III, causing ipsilateral pupil dilation and ptosis, and compresses the contralateral cerebral peduncle causing ipsilateral hemiparesis (Kernohan's notch).

What is the target PaCO2 range in a patient with suspected elevated intracranial pressure (ICP)?

Answer: 35–45 mmHg

Normal PaCO2 (35–45 mmHg) is maintained to avoid hypercapnia (vasodilation worsening ICP) without prophylactic hyperventilation which risks ischemia.

Cushing's triad (hypertension, bradycardia, irregular respirations) signals which emergency?

Answer: Impending brainstem herniation

Cushing's triad is a late sign of rising ICP with impending brainstem herniation requiring immediate intervention.

Which sedation scale is most commonly used to assess depth of sedation in ICU patients?

Answer: Richmond Agitation-Sedation Scale (RASS)

The RASS is the most validated and widely used tool for assessing sedation depth in mechanically ventilated ICU patients, ranging from -5 (unarousable) to +4 (combative).