J Neurosci Nurs. 2020 Jun;52(3):128-131. doi: 10.1097/JNN.0000000000000501.
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.
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.
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.
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.
瞳孔对光反射（PLR）传统上使用笔形手电筒（光）进行评估。尽管经常使用“迅速”或“迟钝”等术语，但尚不清楚 PLR 的哪些特征导致了这种描述。最近，自动红外瞳孔测量法使我们能够量化 PLR 的不同组成部分。
我们对儿科重症监护病房（PICU）护士进行了 2 部分问卷调查。在第 1 部分中，要求护士以自由文本形式描述他们与迅速或迟钝的 PLR 相关的关键特征。在第 2 部分中，在介绍了瞳孔测量法和 PLR 的不同组成部分之后，护士被要求根据潜伏期（瞳孔开始对光反应所需的时间）、变化百分比（光刺激后瞳孔大小的变化）和收缩速度（光刺激后收缩的速度）对“迅速”和“迟钝”描述相对重要性进行排序。
50 名护士做出了回应。在第 1 部分中，“快速”是最常用的术语（36%的受访者）来描述迅速的 PLR，而 72%的人用“缓慢”来描述迟钝的 PLR。大多数描述最接近潜伏期和/或收缩速度的特征。在第 2 部分中，潜伏期被认为是描述迅速（32%）和迟钝（34%）PLR 的瞳孔测量法最重要的组成部分。收缩速度被认为是最重要的，分别为 18%（迅速）和 20%（迟钝），而 44%（迅速）和 46%（迟钝）则将变化百分比排在其他 2 个特征之后。
潜伏期，其次是收缩速度，被 PICU 护士认为是导致床边使用“迅速”或“迟钝”来描述 PLR 的最重要特征。我们计划将这些主观意见与瞳孔测量法的客观发现进行比较。
