Cranial nerves: part 1

02 February 2020
Volume 12 · Issue 2

Abstract

The clinical examination is an important part of any patient consultation. After the primary survey and patient history, a more in-depth examination of the patient is sometimes required to aid the working diagnosis and help negate other differential diagnoses. The extent of this depends on the stability of the patient and may not be possible in time-critical circumstances. However, it is becoming an increasing part of paramedic practice owing to the continued expansion of the scope of the paramedic role in both urgent and emergency care. Educational delivery of clinical examinations of each of the main body systems is now an integral part of undergraduate paramedic curricula.

The forthcoming clinical examination series will provide a step-by-step overview for each of the main body systems. Continuing professional development (CPD) is an essential requirement for all clinicians in order to maintain and demonstrate currency and advancement within their roles. This series will therefore provide an overview of each examination to support students, newly qualified paramedics and paramedics wishing to use these as a CPD development activity and an aide-memoire for clinical practice. This article will provide an overview of initial examination considerations, including first impressions. In this month's edition, cranial nerves I–VI will be explored.

The articles in this series, which can be torn out for use in practice, are intended to support clinician development and to assist in the overall assessment of patient presentations. The information should be used to aid consideration of differential diagnoses in situations where life-threatening conditions have been ruled out.

The extent and explanation of each examination will not be to the depth of those provided in core literature texts, so further reading and consolidation are advised to support understanding, supplemental to these articles. Key questions will be included for reader consideration and to direct further study.

Most examinations are taught in a rigid format. However, in clinical practice, practitioners need to be able to be flexible and adapt their approach dependent on the presenting condition and circumstance. While there is no single set way for each of these examinations, a good structure will reduce omissions and errors, and support the gathering of information to inform patient care.

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