The Art and Science of Distinguishing Disorders of Consciousness

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DEFINITION OF MINIMALLY CONSCIOUS A condition of severely altered consciousness in which minimal but definite behavioral evidence of self or environmental awareness is demonstrated. “ Giacino et al, 2002
MINIMALLY CONSCIOUS STATE: AT LEAST ONE CRITERIA MUST BE MET The key element of the definition is the requirement that there be at least one clear cut behavioral sign of consciousness. Simple command following Gestural or verbal yes/no response Intelligible verbalization Movements or affective behaviors that occur in relation to relevant environmental stimuli Visual or auditory tracking (pursuit) or sustained fixation that is in direct response to moving stimuli An appropriate response to the environment, or situation
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 and 10: DEFINITION OF VEGETATIVE STATE ‣N
Page 11: DEFINITION OF PERSISTENT VEGETATIVE
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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