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RECORD NO: NEUROLOGICAL OBSERVATION CHART

NAME: HOSPITAL NO: DATE: TIME:

TIME TIME

Spontaneous 4
Eye opening

To sound 3 Eyes closed


(E)

To pressure 2 by swelling
None 1 =C
Not testable NT
Orientated 5
Confused 4 Endotracheal
response
COMA SCALE
Verbal

Words 3 tube or
(V)

Sounds 2 tracheostomy
None 1 =T
Not testable NT
Obeys commands 6
Localising 5
Best motor
response

Normal flexion 4
(M)

Abnorma flexion 3
Extension 2
None 1
Not testable NT
1 240
230 40
220 39
2 210 38

Temperature C
200 37
Blood pressure and Pulse rate

190 36
3 180 35
170 34
160 33
4 32
150
140 31
130 30
5
120
110
6 100
90
80
7 70
60
50
8 40
30
Pupil scale Respiration 20
(mm) 10
Size
Right + reacts
Reaction
PUPILS - no reaction
Size
Left c eye closed
Reaction
Normal power
Mild weakness
Arms

Severe weakness
LIMB MOVEMENT

Record right
Spastic flexion (R) and left (L)
Extension seperately if
No response there is a
Normal power difference
Mild weakness between the
Legs

Severe weakness two sides


Extension
No response

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