How do you know when your patient is "waking up": coma recovery assessment in a complex continuing care setting.

How do you know when your patient is "waking up": coma recovery assessment in a complex continuing care setting.
Can J Neurosci Nurs. 2013;35(2):27-33
Authors: Lee TM, Savage J, McKee H, Flament MP, D'Onofrio S, Eckert S
Abstract
Coma, vegetative state (VS) and minimally conscious state (MCS) are disastrous outcomes following severe traumatic brain injury. Due to the extent of the resultant neurological deficits including hemisphere damage, loss of cellular integrity, altered and abnormal movements such as flexor and extensor patterns, and alterations in cranial nerve function, it can become difficult for the interprofessional team to identify when a patient is emerging from their coma. The Glasgow Coma Scale (GCS), commonly used to assess patients with traumatic brain injury (TBI) is not comprehensive or sensitive enough to provide concrete evidence that a patient is emerging from VS to an MCS. The purpose of this paper is to present a case study of a patient who has emerged from a persistent VS to promote a deeper understanding of what is involved when working with this clientele. Challenges in assessment of cognitive functioning, the development of successful communication through the use of technology and the goals of therapy amongst the various health team members will be provided. Collaborative support with the family will also be discussed. Members of the interprofessional team explored the literature to determine coma recover...

Source: Canadian Journal of Neuroscience Nursing - November 18, 2015 Category: Nursing Tags: Can J Neurosci Nurs Source Type: research