Hospital and Telephone Triage

91 videos, 4 hours and 28 minutes

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Video 28 of 91
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Neurological Assessment: Evaluating Pupillary Reflex

Understanding the Importance

During assessment or triage, it's crucial to examine patients for potential head injuries or neurological deficits, as these may indicate underlying brain problems.

Using a Pen Light

A pen light is a valuable tool for detecting signs of brain swelling or pressure on the optic nerve.


  • Clean the pen light before use.
  • Activate the light by pressing the clip.
  • Shine the light into both eyes.
  • Observe pupil reaction to light exposure.


  • Both pupils should retract equally when exposed to light.
  • Repeat the process for each eye individually.

Key Points:

  • Ensure proper positioning of the light to avoid false readings.
  • Use shading if necessary to aid pupil dilation.
  • Check for equal and reflexive pupil responses.


Record pupil size using the numbered scale on the pen torch.

Interpreting Findings

Unequal pupil size may indicate neurological deficits, requiring immediate referral to A&E.