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Neurological observations

What are neurological observations?

Neurological observations are a series of simple tests and observations that help the nurses and doctors who are caring for your child to assess your child’s level of consciousness. The tests and observations involve:

  • waking your child and asking them a few simple questions
  • shining a torch in their eyes
  • testing strength in their arms and legs

This is done alongside all the normal routine observations such as:

  • temperature
  • heart rate
  • blood pressure

You may also hear staff calling this GCS which stands for ‘Glasgow coma scale’.

What is the Glasgow coma scale (GCS)?

Staff do neurological observations in line with the Glasgow coma scale. This scale was developed to give doctors and nurses a reliable and objective method of assessing a individual’s level of consciousness.

When the neurological observations are done, your child will have a score on the Glasgow coma scale between 3 and 15. 3 is the lowest level of consciousness meaning your child is unwell and 15 is the highest meaning your child is fully alert and orientated.

Why do we do them?

These observations are done on any child who is at risk of having an altered level of consciousness. This includes children who have had a head injury, brain surgery or any suspected medical condition that affects the brain, such as meningitis.

The neurological observations and Glasgow coma scale score help us to evaluate how well your child’s brain is functioning and if there are any changes in your child’s condition.

Is it really necessary to wake my child over night?

In the early stages of observing your child it is very important that we wake them often. Children with neurological problems can become unwell very quickly. In order to assess your child’s level of consciousness they need to be awake. To begin with, your child may need to be woken up every half an hour. As your child’s condition improves the frequency of the neurological observations will decrease and we will not need to wake your child as often.

When will you stop doing them?

There is no specific timescale for when we will stop doing neurological observations. The frequency of the observations will be dictated by your child’s stability and condition, and may be changed after a discussion with the doctor looking after your child.

What can I do to help?

The nurses and doctors understand that all children are individual and are at varying stages of development. We also understand that you know your child better than anyone. For this reason it is important that you help us to establish what is normal for them so we can see when something has changed. We also know that some children are quite shy and may not want to speak to nurses and doctors. For this reason you may be asked to participate when we are asking your child questions and trying to get them to speak to us. It is also important that you do not answer the questions for them, as we are trying to how they are actually feeling.

If you have any more question please ask the staff looking after your child.

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

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