The Art and Science of Distinguishing Disorders of Consciousness

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VEGETATIVE STATE: ALL OF THE FOLLOWING CRITERIA MUST BE MET • No evidence of sustained, reproducible, purposeful, or voluntary behavior responses to visual auditory, tactile or noxious stimuli; • No evidence of language comprehension or expression; • Intermittent wakefulness manifested by evidence of sleep-wake cycles on the EEG • Periodic eye opening; • Sufficient preservation of autonomic functions to permit survival with adequate medical care; • Variable preservation of cranial nerve and spinal reflexes; • Incontinent of bowel and bladder.
DEFINITION OF PERSISTENT VEGETATIVE STATE This term was abandoned by the Aspen group based on lack of consensus An ongoing state of unconsciousness Term used to distinguish those who remain in VS for a protracted period time from those who briefly experience VS during the transition from coma to consciousness Denotes ongoing state of unconsciousness whereas recovery of consciousness is highly improbable but not impossible.
Page 1 and 2: The Art and Science of Distinguishi
Page 3 and 4: OBJECTIVES 1. Defining disorders of
Page 5 and 6: INACCURATE DIAGNOSIS MAY LEAD TO:
Page 7 and 8: DEFINITION OF COMA Coma represents
Page 9: DEFINITION OF VEGETATIVE STATE ‣N
Page 13 and 14: MINIMALLY CONSCIOUS STATE: AT LEAST
Page 15 and 16: GOAL OF CLINICAL TEAM Intact Skin
Page 17 and 18: OUTCOME OF PATIENTS AT 3, 6, AND 12
Page 19 and 20: RANCHOS LOS AMIGOS SCALE (REVISED)
Page 21 and 22: JFK COMA RECOVERY SCALE-R Auditory
Page 23 and 24: COMA RECOVERY SCALE-R Visual Functi
Page 25 and 26: COMA RECOVERY SCALE-R Oromotor/Verb
Page 27 and 28: COMA RECOVERY SCALE-R Arousal Sub-s
Page 29 and 30: ARE YOU GETTING THE BEST ASSESSMENT
Page 31 and 32: MEDICAL ISSUES
Page 33 and 34: DYSAUTONOMIA Alterations in autonom
Page 35 and 36: STORMING MANAGEMENT 1. Overstimulat
Page 37 and 38: FIRST “DO NO HARM” Eliminate m
Page 39 and 40: NEUROTRANSMITTER ROLES DOPAMINE: i
Page 41 and 42: SLEEP MEDICATIONS Often alertness
Page 43 and 44: AGITATION Avoid sedatives, benzodi
Page 45 and 46: WHAT’S THE RECIPE? INDIVIDUALIST
Page 47 and 48: MAXIMIZE THERAPEUTIC BENEFIT OF REH
Page 49: REFERENCES: Fins. J., Master, G.,

The Art and Science of Distinguishing Disorders of Consciousness

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