Coma Recovery : Steps And Understand The Brain

In the article “This is your Brain…” by Roy Wood and Patrick Barker is about understanding the brain and the limitations that the brain has. That the brain controls our body and everything that happens in our body. That there is so much more that the brain does then we ever give it credit for. The brain has three important things the bad attributes, the neocortex and limbic system, and the manages energy.

Dr. Fox is an emergency physician at UCI Medical Center, treating and diagnosing patients using an ultrasound. His scope of research involves looking at patients’ internal organs via ultrasound, which is much quicker and less harmful than using x-ray scans that are traditionally used in emergency departments. He is also a part of the American Institute of Ultrasound in Medicine (“Faculty and Staff”). Dr. Fox is also a director of instructional ultrasound and is the assistant dean at the UCI School of Medicine (“John Christian Fox”). He started an ultrasound rotation at the UCI School of Medicine, and with a grant given by SonoSite, Inc., the ultrasound curriculum is now embedded within the UCI School of Medicine curriculum (“Faculty and Staff”). He went to Tufts University School of Medicine, receiving his MD in 1997 (“John Christian Fox”). His main research focus is to try to incorporate ultrasound more into the emergency department, and tries to find revolutionary ways to utilize ultrasound, especially because it is very cost-efficient and images are seen real-time, unlike MRI scans or x-rays, which can emit harmful radiation or results take much longer to acquire. Eric Viquez is one of the Bio 199/EMRAP (Emergency Medicine Research Associates Program) students in Dr. Fox’s ultrasound lab. He is currently a 4th year undergraduate biological sciences major who is going to medical school in the fall; he shadows shifts with Dr. Fox and

The Glasgow coma scale is the scoring system that monitors and assesses the level of consciousness of a patient that has had a traumatic injury e.g. brain injury, car accident or sports injury (Braine & cook, 2016). The Glasgow coma scale is a score between 3-15 with 3 being the worst and 15 being the best. This scale is composed of 3 sections which are the best eye response this assessment is important to assess the arousal of the patient which reflexes the integrity of reticular activating system of the brain which assesses by 1. No eye opening 2. Opens to pain 3. Opens to voice 4. Opens spontaneously, the best verbal response this assessment reflects the integrity of higher cognitive and interpretive centres of the brain. The verbal response depends on the language centre in the temporal lobe and in the frontal lobe which assess 1. No verbal response 2. Incomprehensive sounds 3. Inappropriate words 4. Confused 5. Orientated and best motor response this assessment check the function ability of the cerebral cortex, the patient has to understand the commands and perform the movement accordingly, they assess the upper extremities by simple orders because they are more reliable than the lower extremities this is assessed by 1. No motor response 2. Extension to pain 3. Flexion to pain 4. Withdrawals from pain 5. Localising pain 6. Obeys commands, these are the three sections that nurses needs to access (Elliot, Aitken & Chaboyer,

The authors/researchers began with one hundred twenty brains that were divided into the following groups: 97 brains from SIDS victims and 23 from victims which died having no occurrence of brain damage.

Changes in the brain-death statute were made relatively recently by the governor; there is now more reliance on clinical evaluations and trancranial Doppler tests. Doppler ultrasound assesses measurements of blood flow. Used noninvasively, an ultrasonic signal transmission is carried through the body. The echo signal returns from red blood cells – the return signal yields a Doppler shift signal (Bay, 1999).

American Heart Association (AHA) estimates that nearly 700 Americans die each day of sudden cardiac arrest (MI), or 250,000 every year, as many as 50,000 lives could be saved each year if certain critical interventions were made. (Freeman , 50) A patient who receives early life support measures and defibrillation within one to five minutes of arrest is much more likely to live and to retain normal brain function. The brain is often at a serious risk for irreparable brain damage related to anoxia and many other co-morbidities that are associated with cardiac arrest (MI). When a perfusing cardiac rhythm returns after a heart attack, the most important objective is to preserve brain function. The AHA and the Advanced Life Support Task Force of

A Glasgow Coma Score of 8 or less also is an indication that the patient will need to be intubated soon. Once the tube is placed the ventilation may be useful in controlling the intracranial pressure as an intervention. Hyperventilation is a method used to reduce the carbon dioxide concentration in the vessels causing vasoconstriction which lessens the amount of blood circulating in the brain resulting in a decreased ICP (Zink and McQuillan, 2005). According to Zink and McQuillan, this intervention should only be utilized 24 hours after the initial injury because cerebral blood flow is often reduced at this point and constricting the vessels more may cause ischemia to occur. While using this technique it is important to monitor oxygenation to the brain tissue to assure no irreparable damage is

Traumatic Brain Injury isn’t a true leading cause of death but also represents a financial and personal burden, on the individual and the family. The injury affects all 3 parts within the intracranial space, also includes brain bulk, Cerebrospinal Fluid (CSF), and brain blood volume. Brain bulk increases after water influx to brain tissue or inflammatory response. CSF dynamics can be changed because of communicating hydrocephalus. Brain blood volume within the arterial and venous systems may cause a secondary injury. Also, it says, Intracranial pressure monitoring possibly will be effectively done by the means of an intraventricular catheter, enabling Cerebrospinal Fluid drainage and providing excellent Intercranial Pressure waveforms, facilitating ICP pulse-wave assessment of intracranial compliance.

In neropsychology, there are many assessments and tests such as the Glascow Coma Scale, the NAART, the Weschler WTAR, all of these and more can be used to assess Mary’s premorbid abilities and compare them to after her accident. In the Glascow Coma Scale, one of the assessed on the following functions, eye opening, verbal response, and motor response (Tsdale, Jennett. 1974). Eye opening can be spontaneous, to the sound of a voice, and response to pain, or not at all (Tsdale, Jennett. 1974). Verbal response can be normal conversation, disorientated conversation, words, but not coherent, no words, only sounds, or none at all (Tsdale, Jennett. 1974). Motor response can be normal, localized to pain, withdrawal to pain, abnormal posture, or none (Tsdale, Jennett. 1974).

This article is a example of a foundation of knowledge on the topic of therapeutic hypothermia. Gardner & MacDonald discuss that the typical post cardiac arrest patient does not survive or will recover with severe neurologic deficits as a result of ischemic brain injury from lack of blood flow to the brain (2013). The process of brain death is examined as well as the damange that occurs with reperfusion after ROSC. Damage particularly to the cerebral cortex, cerebellum and hypothalamus can leave the patient in a comatose state if revived (Gardner & MacDonald, 2013). This article is particuarlly valuable as it explains on a physiological level how TH protects the brain from reperfusion injury and improves neurologic outcomes and survivability. The article defends that TH is the best practice for preventing further neurologic damage after ROSC and provides a clinical example. The clinical example recounts a case in which a patient suffered an out of hospital cardiac arrest. Upon admission to the ICU the therapeutic hypothermia protocol was initiated and the patient was cooled below 35 degrees celcius for 24 hours. After rewarming the patient regained consciousness and within ten days was discharged from the hospital with normal neurologic function and as a survivor (Gardner & MacDonald,

To begin with, according to an article written by Lyons, MD, “Deep brain stimulation (DBS) has developed during the past 20 years as a remarkable treatment option for several

As a 25-year-old man recovers from his coma the doctors thought it would be a good idea to use a ultra sound.The technique they used was sonic stimulation to excite the neutrons in the thalamus that is an egg-shaped structure that serves as the brains central fun for progressing information.The doctor says "Our approach directly targets the thalamus but is noninvasive."This action took place in The University Of California-Los Angeles.Written by Stuart Wolpert."These changes are remarkable,"Monti said. "Ultra-Sound Jumpstarts A Mans Brain After Coma"

An assessment of the level of consciousness (LOC) should be carried out during the primary survey of all patients, using the ABCDE approach Cole (2009: 28). Any initial or subsequent reduction in the LOC of the patient may be caused by hypoxia; hypovolaemia; head injury; drug or medicine use; hypoglycaemia; hypothermia or alcohol ingestion (Cole, 2009:44).

According to the Centers for Disease Control and Prevention, over 1.7 million people in the United States sustain brain damage annually (Fual, Waul and Coronado 2010). Often these cases result in coma and vegetated states, leaving families and friends with a hard choice. Do they allow their loved one to live as vegetable or pull the plug and move on with their own lives? New studies suggest that even though a person may not seem conscious, they very well might have higher brain function. With the possibility of consciousness, comes the need to reevaluate the options, we need to give some of these people a chance.

This method does not take into account the possibility of weak conscious knowledge, we cannot report on that which we are unaware of. One study involving a 31 year old female patient (GR) whom, for a few months, had experienced severe headaches. Suddenly, she was hit with a massive headache, then blindness on the right side of her visual field, and dropped to a level 12 Glasgow Coma Score (GCS – an objective way of recording the conscious state of a person. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3, indicating deep unconsciousness, and either 14 (original scale) or 15, the more widely used modified or revised scale). The results of a CT scan of her cerebral lobe indicated an anterior left occipital lobe hemorrhage, surrounding the subarachnoid space, and expanding to the left lateral ventricle, resulting in a moderate hydrocephalus (swelling of the head). The next day, her GCS decreased to 7, and a new CT scanning showed increased hydrocephalus. A drain was placed in the right lateral ventricle to drain CSF. Angiography showed an arteriovenous malformation. The malformation was treated with endovascular (of or relating to a surgical procedure in which a catheter containing medications or miniature instruments is inserted through the skin into a blood