Understanding Sensory Assessment for Student Nurses
Learn how to assess sensation, compare both sides of the body and recognise new numbness, tingling or sensory loss as part of a wider neurological assessment.
What do we mean by sensation?
Sensation allows the nervous system to detect information from the body and environment. Neurological illness or injury can alter how a patient experiences touch, pain, temperature or the position of a limb.
Can the patient feel contact?
Light-touch sensation may be compared between corresponding areas of the body when appropriate.
Numbness or tingling
Patients may describe reduced feeling, pins and needles or unusual sensations.
Compare both sides
A new difference between the left and right sides can be an important neurological finding.
What sensory changes might a patient report?
Reduced or absent feeling
The patient may describe part of the body as numb or less sensitive than normal.
Pins and needles
Tingling or abnormal sensations may occur in an arm, leg, face or another body region.
One side feels different
The patient may notice that touch feels different on one side of the body compared with the other.
Pattern matters
Note whether the change affects the face, arm, leg, one side of the body or a smaller localised area.
Daily activity may change
Altered sensation may affect grip, walking, coordination or the patient's confidence using a limb.
Ask when it began
Sudden onset is particularly important when considering acute neurological deterioration.
Compare, don't simply test
A useful sensory assessment looks for differences from baseline and differences between corresponding areas of the body. Follow the technique used in your clinical area and work within your level of competence.
Explain the assessment
Tell the patient what you are going to assess and gain their cooperation.
Establish baseline
Ask whether they normally experience numbness, altered sensation or neurological symptoms.
Compare corresponding areas
When appropriate, compare similar locations on both sides rather than interpreting one area in isolation.
Document the difference
Record where altered sensation is found and whether it is new or changing.
Sensation should not be interpreted alone
New sensory loss becomes more concerning when it appears alongside other focal neurological findings.
Is there weakness?
Compare sensation with limb movement and strength.
Is facial sensation or movement different?
New facial change can contribute to a focal neurological pattern.
Has communication changed?
New aphasia or dysarthria occurring with sensory change requires urgent assessment.
Is the patient less responsive?
Sensory change with reduced consciousness may represent more significant neurological deterioration.
Any visual disturbance?
Sudden visual change can occur alongside other acute neurological deficits.
Was the onset sudden?
Sudden focal sensory change should be treated differently from a long-standing stable symptom.
New unilateral numbness together with weakness or speech change is much more concerning than an isolated long-standing sensory symptom.
When sensory findings need urgent escalation
- Sudden numbness affecting one side of the face or body.
- New sensory loss with arm or leg weakness.
- New numbness with facial asymmetry.
- New sensory change with slurred speech or aphasia.
- New sensory change following a head injury.
- Sensory changes associated with reduced consciousness.
- Rapidly worsening neurological symptoms.
- Any new focal neurological deficit that differs from baseline.
Place sensory findings within the wider assessment
Airway
Assess airway patency and respond immediately if it is compromised.
Breathing
Assess respiratory rate, oxygen saturation, respiratory pattern and work of breathing.
Circulation
Assess pulse, blood pressure and perfusion within the wider clinical picture.
Disability
Assess consciousness, pupils, movement, strength, speech, sensation and blood glucose according to local practice.
Exposure
Look for injury or other clinical findings while maintaining dignity and comfort.
Escalate
New neurological changes require prompt communication and senior clinical review.
Recognising a focal sensory change
Example
A patient who had been mobilising normally tells you that their left arm suddenly feels numb and “different”.
When you compare both sides, they report reduced sensation in the left arm. You also notice that their left hand grip appears weaker than earlier.
Their speech then becomes slightly slurred.
You recognise the pattern: sudden unilateral sensory change + weakness + speech change.
You immediately perform a structured assessment, establish when the patient was last known to be at their normal baseline and escalate the neurological change according to the local emergency pathway.
Describe the location and change
Example escalation
“I'm concerned about Mrs Taylor. She has developed sudden reduced sensation in her left arm compared with the right. Her left hand also appears weaker and her speech has become slightly slurred.”
This communicates the location, side, new sensory deficit and associated neurological changes.
Sensory assessment errors to avoid
- Testing sensation without establishing the patient's baseline.
- Failing to compare corresponding areas on both sides.
- Documenting “numbness” without recording where it occurs.
- Ignoring whether the symptom began suddenly or gradually.
- Assessing sensation without checking movement and strength.
- Ignoring associated speech, facial or visual changes.
- Assuming all tingling has a neurological cause.
- Waiting for a new focal deficit to resolve before escalating.
Observe → compare → connect → escalate
Identify the sensory change
Ask what feels different and where the change is located.
Compare sides and baseline
Look for asymmetry and connect sensation with movement, speech and other neurological findings.
Report new focal changes
Describe exactly what has changed, where it is and what other neurological signs are present.
Build a complete neurological picture
Sensory assessment becomes much more meaningful when it is connected with consciousness, pupils, limb strength, speech and change from the patient's normal baseline.
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