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5 Minute Neurological Exam

Any diver can follow this 5 minute Neuro

 

  1.                   Orientation.–  Does the diver know name and age? Location? What time, day and year it is? Note: even though the diver appears alert, the answers to the question may reveal confusion, so do not omit them.
  2.                   Eyes. – Have the diver count the number of fingers you display using 2 or 3 different numbers. Check each eye separately and then together. Have the diver identify a distant object. Tell the diver to hold his head still, or you gently hold it still, while placing your other hand about 18” in front of their face.  Ask the diver to follow your hand with his eyes. Move your hand up, down, side to side. The divers’ eyes should smoothly follow your hand and should not jerk to one side and return. Check pupils are of equal size. Note: Often AGE victims have different dilation in one eye than the other. Also look for Nystagmus (fluttering of the eyes either vertically or horizontally). This is a sign of neurological problems, with vertical fluttering being associated with more severe damage.
  3.                   Face. – Ask the diver to whistle. Look carefully to see that both sides of the face have the same expression while whistling. Ask the diver to grit his teeth. Feel the jaw muscles to confirm that they are contracted equally. Instruct the diver to close their eyes while you lightly touch your fingertips across the forehead and face to be sure sensation is present and the same everywhere.
  4.                   Hearing. – Can be evaluated by holding your hands about 2 feet from the diver’s ears and rubbing your thumb and finger together. Check both ears, moving your hand closer until the diver hears it. If the surroundings are noisy (i.e.: a crowed beach), the test can be difficult to evaluate. Ask bystanders to be quite and turn off unneeded machinery.
  5.                   Swallow reflex. – Instruct the diver to swallow while you watch the Adams apple to be sure that it moves up and down.
  6.                   Tongue. – Instruct the diver to stick out their tongue. It should come out straight in the middle of the mouth without deviating to either side.
  7.                   Muscle strength. – Instruct the diver to shrug the shoulders while you bear down on them to observe for equal muscle strength. Check the divers arms by bring the elbows up level with the shoulders, hands level with the arms and touch the chest. Instruct the diver to resist while you pull the arms away, push them back, up and down. The strength should be approximately equal in both arms in each direction. Check leg strength by having the diver lie flat and raise and lower the legs while you gently resist the movement.
  8.                   Sensory perception.The divers eyes should be closed during this procedure. Check both sides by touching as done on the face. Start at the top of the body and compare sides while moving downwards to cover the entire body. The diver should confirm the sensation in each area before you move to another area.
  9.                   Balance and coordination.Be prepared to protect the diver from injury when performing this test. Have the diver stand with feet together, close eyes and stretch out arms. The diver should be able to maintain balance if the platform is stable. Your arms should be around the diver, but not touching the diver. Be prepared to catch the diver who starts to fall. Note: If the diver is already messed up you may want to avoid this one. If he can’t stand check coordination by having the diver move an index back and forth rapidly between divers’ nose and your finger held approximately 18” from the divers face. Instruct the diver to slide the heel of one foot down the shin of the other leg. The diver should be lying down when attempting this test.  Check these test on both legs and observe carefully for unusual clumsiness on either side.

 Remember to note all your findings.

 

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