When observing unequal pupils in a patient, what should be documented first?

Documenting the size and reaction time of each pupil is crucial in assessing unequal pupils, a condition known as anisocoria. This measurement provides immediate clinical information that can indicate underlying neurological conditions or issues with the eye.

For instance, if one pupil is larger than the other, it may suggest a problem such as increased intracranial pressure or a potential cerebral herniation, while differences in reaction time can help infer the functioning of the optic and oculomotor nerves. By capturing these measurements first, healthcare providers can make more informed decisions about further care and interventions based on the objective data collected at the moment of observation.

Gathering the patient's medical history or asking about prior findings might provide useful context, but they do not offer the immediate clinical assessment required for potentially urgent situations. Notifying the healthcare provider is also essential, yet it should typically be done after gathering primary assessment data, ensuring that the most critical information about the patient's current neurological status is available for timely decision-making.