If pupillary changes are identified early, diagnostic and treatment intervention can be delivered in a more timely and effective manner. Standardized use of pupil assessment tools such as a pupillometer is necessary to increase accuracy and consistency in pupil measurement and to potentially contribute to earlier detection of subtle changes in pupils. In addition, nearly all nurses relied on subjective estimation, even when tools were available.Ĭritical care and neurosurgical nurses underestimated pupil size, were unable to detect anisocoria, and incorrectly assessed pupil reactivity. ![]() ![]() Nurses also failed to detect anisocoria and misidentified pupil reactivity. Across all phases of the study, pupil diameters were underestimated and the rate of error increased as pupil size increased. Subjective assessments of pupil diameter and symmetry were not accurate. The study included assessment of drawings of eyes with an iris and pupil, examination of photographs of human eyes, and bedside examination of patients with a head injury. In a 3-part study, the accuracy of critical care and neurosurgical nurses' assessments of pupils was determined. To evaluate nurses' abilities to assess pupil diameter accurately and detect unequal pupils. Previous research has shown inconsistencies in pupil measurement that are most likely due to the subjective nature of measuring pupils without the assistance of technology. ![]() Early detection of pupillary changes in patients with head injuries can alert the care team to increasing intracranial pressure.
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