High Variance in Pupillary Examination Findings Among Postanesthesia Care Unit Nurses

Purpose: On arrival to the postanesthesia care unit (PACU), patients are observed closely for significant neurological status changes. In particular, patients require frequent neurological examinations, which include assessment of the pupils for changes and/or abnormalities. Design: This is a prospective, nonrandomized, observational study to examine the findings of pupillary examinations by nurses using different light sources in patients with existing pupillary assessments as ordered by standard of care. Methods: PACU nurses were asked to perform their pupillary assessments using either a penlight with a gauge or a penlight without a gauge. Assessments were completed on the same patient within 5 minutes of one another, and results were compared. Finding: PACU nurses using the same penlight with a gauge had more consistent results than those using different penlights without a gauge. Conclusions: Pupil assessments should be done with standardized light source.