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NEUROLOGICAL ASSESSMENT FLOW SHEET

DATE:TIME:(Military Time)EYES 4 = SPONTANEOUSOPEN 3 = To SPEECH2 = To PAIN1 = NONEC = Eyes CLOSED by EdemaBEST 5 = ORIENTEDVERBAL 4 = CONFUSEDRESPONSE 3 = Inappropriate WORDS2 = Incomprehend. SOUNDS1 = NONET = ET / TrachBEST 6 = Obeys CommandsMOTOR 5 = LOCALIZES (Pain)RESPONSE 4 = WITHDRAWS (Pain)3 = FLEXION (Pain)2 = EXTENSION (Pain)1 = NONE GLASCOW COMA SCALE TOTAL:PUPIL SIZE: REACTION REACTION: B = BRISKN = NO REACTIONS = SLUGGISHC = EYES CLOSEDPUPIL SIZE: REACTION REACTION: ARMS NP = Normal PowerW= WeaknessNR= No ResponseLEGS NP = Normal PowerW= WeaknessNR= No ResponseREFLEXES CORNEAL: P =PRESENTGAG: A =ABSENTBABINSKI: SEIZURE ACTIVITY: BREATHING PATTERN: INTIALS:8850319 Rev.

DATE: TIME: (Military Time) EYES 4 = SPONTANEOUS OPEN 3 = To SPEECH 2 = To PAIN 1 = NONE C = Eyes CLOSED by Edema BEST 5 = ORIENTED VERBAL 4 = CONFUSED RESPONSE 3 = Inappropriate WORDS 2 = Incomprehend. SOUNDS 1 = NONE T = ET / Trach BEST 6 = Obeys Commands MOTOR 5 = LOCALIZES (Pain) RESPONSE 4 = WITHDRAWS …

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