How to Perform Neurovascular Assessments on Patients
Neurovascular assessments are performed on patients to assess for adequate nerve function and blood circulation to the parts of the body. These assessments are often performed when a patient has suffered an injury or trauma, require a cast or have a restrictive bandage in place. Nurses are often responsible for performing assessments in order to detect signs and symptoms of potential complications. Neurovascular assessments consist of five different checkpoints, which guide medical personnel when assessing circulatory and nerve function.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Ask the patient if he is experiencing any pain. Note the location, radiation and severity of pain as well as anything that seems to relieve or worsen the pain. Ask the patient to rate his pain on a scale of one to ten with one being no pain at all and ten being the worst pain ever.
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Monitor for signs and symptoms of compartment syndrome 2. Compartment syndrome is the buildup of unrelieved pressure in a limb that results in irreversible tissue damage, loss of sensation, infection and amputation 2. Complaints of severe pain, aggravated by movement and unrelieved by medication, are often the first signs of compartment syndrome and should be reported to the physician immediately 2.
Check capillary refill time by pressing on the tips of fingernails and toenails to ensure proper blood flow. The tissues will turn a pale color while you apply pressure to the area, but digits should return to a normal pink color within three seconds of pressure withdrawal. Assess for color and temperature changes above and below the injured area, which may indicate insufficient blood flow.
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Assess for weakness or paralysis in the injured limb. Lead the patient through range-of-motion exercises and note any deficits in movement or strength in the injured extremity. Monitor for severe pain and muscle spasms during movement. This may indicate the patient may have tendon or nerve damage.
Ask the patient if she is experiencing any changes in sensation, such as numbness or tingling in the extremity. Check for loss of sensation by touching above and below the injured area, then watch for verbal or nonverbal reactions to the stimuli. Document and report any loss of sensation or absence of sensation in the affected area.
Check for pulses in the wrists and feet while noting the rate and quality of blood flow in each extremity. Use the pads of your index and middle fingertips to gently press on the pulse to obtain an accurate reading. Check for a decrease or absence of pulse, which indicates reduced blood flow to the area.
Compare findings on both sides of the body, as well as above and below the injured area. Changes and inconsistencies are a good indication of reduced blood flow or nerve damage, which should be reported to the physician. If possible, compare your findings to baseline results obtained before the injury for a more accurate neurovascular assessment.
Tips
Compare your findings on both sides of the body to better recognize subtle changes in condition.
Warnings
Monitor for signs of infection in the injured limb such as increased redness, warmth or swelling near the injured area.
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References
- "Straight A's in Medical-Surgical Nursing": Springhouse: 2007
- Drugs.com: Compartment Syndrome
- Buerba RA, Fretes NF, Devana SK, Beck JJ. Chronic exertional compartment syndrome: current management strategies. Open Access J Sports Med. 2019;10:71–79. Published 2019 May 23. doi:10.2147/OAJSM.S168368
- Joyner MJ, Casey DP. Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs. Physiol Rev. 2015;95(2):549–601. doi:10.1152/physrev.00035.2013
- Chandwani D, Varacallo M. Exertional Compartment Syndrome. [Updated 2019 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Zimmermann WO, Hutchinson MR, Berg RVD, Hoencamp R, Backx FJG, Bakker EWP. Conservative treatment of anterior chronic exertional compartment syndrome in the military, with a mid-term follow-up. BMJ Open Sport & Exercise Medicine. 2019;5(1). doi:10.1136/bmjsem-2019-000532
- Fraipont MJ and Adamson GJ "Chronic Exertional Compartment Syndrome" J. Am. Acad. Ortho. Surg., July/August 2003; 11: 268 - 276.
Tips
- Compare your findings on both sides of the body to better recognize subtle changes in condition.
Warnings
- Monitor for signs of infection in the injured limb such as increased redness, warmth or swelling near the injured area.
Writer Bio
Roseanne Omalacy became a published author and freelance writer in 2006. She is the author of several novels and has been published with Literary Partners Group, Alyson Publishing and "Scarlet Magazine." She is a Pittsburgh health and relationships columnist, holds a bachelor's degree in nursing from Pennsylvania State University and has over 15 years of nursing experience.