hey everyone it's Sarah with register nurse rn.com and in this video we're going to talk about how to check the pupils with a pin light so whenever you're doing your assessments on your patients you'll want to be checking neurostatus and one thing that I think as nurses we under use are our pen lights these things are cheap you can get disposable ones you can get ones that take batteries they are so handy especially when checking those pupil reflexes so in this video I'm going to go over how you do that and I'm going to actually show you how to check pupils on a patient so let's get started whenever you're using your PIN light I recommend that you get you a good pin light that shows has a little gauge thing you can go by that shows you the size of what pupils are because that will help you when you're gauging the size of your pupils a normal size of a pupil is anywhere from 3 to 5 mm and the shape you want them to be round and what you're going to be looking for whenever you're shining this pinlight you're going to be looking for a direct response and a consensual response the direct response is when you shine light into one eye and you're looking specifically at that pupil to see if it constricts and how well it does then when you're doing consensual you're going to go in and you're going to look at the opposite eye and make sure that those two pupils are constricting simultaneously together so you're at two things direct and consensual then in order to do that you want to have the room dim and you want your PIN light then you'll want to look at accommodation this is where you have the eyes fixated on something in front of the patient you can use your finger you can use the pinlight whatever you want to do and you're going to slowly move it towards the patient's face and you're going to look at those pupils see how well they're fixating on the object are they doing it together and are those pupils constricting as the object moves Clos closer then after you get done with that you can document as we know in the nursing World p e r r l a which means pupils equal round reactive to light and accommodation or accommodating so let's actually see this skill in use okay we're going to use our pin light and we are going to be looking for a direct response which means whenever we shine light into the ey we're Shining Light we're looking at the pupil to see if it constricts and we're also going to look for consensual response it's when we shine light into this ey and we're seeing if this pupil constrict simultaneously with this eye then we're going to look at accommodation response whenever the patient fixates thems on an object far away and we see how well their pupils respond whenever the objects move closer to them so let's get started the very first thing we want to do is we want to look at the eyes and we want to see look at the the pupils and see how round they are make sure they're equal and the size of them and on your PIN light you have little sizes and usually normal sizes of pupils are 3 to 5 mm and our patient here size of his pupil is about a five and whenever you're checking for direct and consensual response you want to dim the lights like this and what you want to do is you begin by shining the light in one eye and you're looking at the response of the pupil and as you can tell his pupil dilates very nicely and brisly that's the direct response now we're going to look in this opposite eye whenever I shine light into this eye and see how this pupil responds so let's do that his pupil responds just like the direct response it constricts and it dilates back normally and you want to shine it in both eyes just back and forth you can also do what's called The Flash I mean The Swinging test with this and what you do is you swing the lie in between the two eyes every two to three seconds like this and you're just watching for pupil response and you get the same reaction now let's look at accommodating response and what we're going to have him do is we're going to hold the object about couple feet away from his face and I'm going to bring it in slowly close to his nose and have him fixate on the object and we're going to watch his pupils to see how they accommodate to that and his pupils accommodate appropriately now what you will document is that it's p r r l a which means pupils are equal round reactive to light and has accommodation so that is how you check a pupil reflex I hope this video helped you out be sure to check out my other nursing skill videos and subscribe to this YouTube channel and thank you so much for watching