BACKGROUND 

Pupillary light reflex (PLR) has traditionally been assessed using a pen torch (light). Although the terms “brisk” or “sluggish” are often used, it is unclear what characteristics of the PLR result in this description. More recently, automated infrared pupillometry has enabled us to quantify the different components of a PLR.

METHODS 

We conducted a 2-part questionnaire survey of pediatric intensive care unit (PICU) nurses. In part 1, nurses were requested to describe the key characteristics that they associate with a brisk or sluggish PLR in free-text responses. In part 2, after an introduction to pupillometry and the different components of a PLR, nurses were asked to rank the relative importance of latency (time taken for pupil to start reacting to light), percentage change (in pupil size after light stimulus), and constriction velocity (rate of constriction after light stimulus) in relation to a pupil being described as “brisk” and “sluggish.

RESULTS 

Fifty nurses responded. In part 1, “Quick” was the commonest term used (36% of respondents) to describe a brisk PLR, and 72% used “slow” for a sluggish PLR. Most descriptions most closely mapped to features of latency and/or constriction velocity. In part 2, latency was ranked the most important component on pupillometry for describing brisk (32%) and sluggish (34%) PLRs. Constriction velocity was ranked as the most important by 18% (brisk) and 20% (sluggish), whereas 44% (brisk) and 46% (sluggish) ranked percentage change behind the other 2 characteristics.

CONCLUSION 

Latency, followed by the constriction velocity, was felt by PICU nurses to be the most important characteristic of the PLR that results in terms “brisk” or “sluggish” being used at the bedside to describe a PLR. We plan to compare these subjective opinions with objective findings from pupillometry.

中文翻译：

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轻快或迟钝的瞳孔光反射的特征：护理观点。

背景 

传统上，使用笔电（光）评估瞳孔的光反射（PLR）。尽管经常使用术语“轻率的”或“缓慢的”，但不清楚在此描述中会产生PLR的哪些特征。最近，自动红外光瞳法使我们能够量化PLR的不同组成部分。

方法 

我们对小儿重症监护室（PICU）护士进行了分为两部分的问卷调查。在第1部分中，要求护士在自由文本回复中描述与轻快或呆滞的PLR相关的关键特征。在第2部分中，介绍了瞳孔测量法和PLR的不同组成部分后，要求护士对潜伏期（瞳孔开始对光做出反应所花费的时间），百分比变化（受光刺激后的瞳孔大小）的相对重要性进行排名，相对于瞳孔的收缩速度（光刺激后的收缩率）被描述为“轻快”和“呆滞”。

结果 

五十名护士回应。在第1部分中，“快速”是用于描述轻快的PLR的最常用术语（占受访者的36％），而72％的人将“缓慢”用于表示呆滞的PLR。大多数描述最紧密地映射到潜伏期和/或收缩速度的特征。在第2部分中，对于描述轻快（32％）和缓慢（34％）的PLR，延迟是瞳孔计量学上最重要的组成部分。收缩速度以18％（轻度）和20％（缓慢）为最重要，而44％（轻度）和46％（缓慢）则将变化百分比排在其他2个特征之​​后。

结论 

PICU护士认为延迟和紧随其后的收缩速度是PLR的最重要特征，导致床旁使用“轻碰”或“呆滞”来描述PLR。我们计划将这些主观意见与瞳孔测量的客观发现进行比较。