There are two types of stimuli used durign neuro assessments such as in the Glasgow Coma Scale: central stimuli, and peripheral stimuli.
With central stimuli, pressure is applied to the center of the body to create pain. This tests the brain’s response to it.
The trapezius squeeze is one technique to do this. Use the index finger and thumb to squeeze about 1.5 – 2 inches of the trapezius muscle, gradually increasing pressure for up to 10 seconds.
Supraorbital lpressure is anothoer technique that you can use if no response occurs during the trapezius squeeze. Find the notch of the eyebone inferior to the medial part of either eyebrow. Apply pressure with the thumb for up to 10 seconds.
Of course, before assessing a patient, you always want to follow your facility’s protocols. Some of these assessments may not be appropriate if the patient has an injury or other issue in these areas.
Peripheral stimuli is another way to assess neuro status, and this method applies pressure to an extremity, such as the nail bed by using a penlight or other instrument.
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