Neurovascular observation and documentation for children within Accident and Emergency: A critical review

SummaryThis paper aims to review the ‘evidence base’ in relation to neurovascular assessment tools suitable within the Accident and Emergency setting. The culled literature which incorporated benchmarks and clinical guidelines confirmed a lack of literature on neurovascular assessment pertaining to paediatrics with only one tool identified which had been evaluated for paediatric use. There did appear to be a general consensus that the assessment should be based on the “5 P’s” i.e. pain, pulses, pallor, paraesthesia and paralysis, with pain considered a more reliable indicator and with frequency of assessment undecided. The review concludes that in order to undertake effective neurovascular assessment in children, the nurse should use an appropriate tool, document using either a neurovascular chart or flow sheet, with findings communicated effectively within disciplines. The children’s nurse should also hold an orthopaedic related qualification.