Across NHS emergency and critical care services, patients with suspected or evolving neurological injury frequently move between multiple teams and care environments — from pre-hospital response and emergency departments, through inter-hospital transfer, to critical care units and Major Trauma Centres (MTCs).
Throughout this pathway, pupil assessment remains a core component of neurological examination. However, traditional pen torch assessment is subjective and can vary depending on the clinician, environment and clinical context. This variability can make it challenging to interpret change over time, particularly as patients transition between services.
Objective, trendable pupil assessment that travels with the patient
The Neurological Pupil Index (NPi®) was developed to provide an objective, quantitative assessment of pupil reactivity by analysing the entire pupillary light reflex and presenting the result as a single numerical score.
Using the NeurOptics® NPi®-300 automated pupillometer, clinicians can obtain fast, accurate and user-independent NPi measurements across different settings — supporting consistency from first patient contact through to definitive care.
The importance of trendable data
While a single assessment provides useful information, the true value of NPi lies in its ability to be trended over time.
NPi measurements taken pre-hospital, repeated in A&E, monitored during transfer and continued in ICU or the MTC create a shared neurological timeline. This supports earlier recognition of change, clearer communication at handover, and more informed clinical decision-making alongside other physiological and neurological data.
Supporting safer handover and regional working
NPi results are displayed as a simple numerical value, making trends easy to interpret and communicate between teams. Built-in patient identification supports safe patient matching, helping ensure continuity of data as responsibility for care changes.
In a regionalised NHS model — where transfer services, emergency departments and specialist centres work closely together — objective, user-independent measurements support a common clinical language and reduce reliance on subjective interpretation alone.
A complementary tool within neurological assessment
NPi does not replace clinical judgement. Instead, it provides an additional, standardised data point that supports neurological assessment across the pathway, helping teams make timely, well-informed decisions in complex and time-critical situations.
Discover more about NPi and the NeurOptics Pupillometer here
