Disorder of Consciousness Flashcards
RLAS R 1
no response: total assistance
complete absence of observable change in behavior when presented visual, auditory, tactile, proprioceptive, vestibular or painful stimuli
RLAS R 2
generalized response: total assistance
generalized reflex response to noxious stimuli
rancho 2 responds to what kind of stimuli
- repeated auditory stimuli with increased or decreased generalized activity
- external stimuli with physiological changes generalized, gross body movement and/or not purposeful vocalization
RLAS R 3
localized response: total assistance
demonstrates withdrawal or vocalization to painful stimuli
what brainstem involvement do you see with comas
midbrain, pons –> reticular formation
what injuries are u likely to see with cortical lesions
diffuse injury and/or significant thalamic involvement
when you shift to level 2, what improves due to the brainstem
- preserved capacity for spontaneous of stimulus-induced arousal
- sleep/wake cycles
- improved control of vital functions
one or more of what behaviors must be present to distinguish btw MCS from VS
- simple command following
- gestural or verbal yes/no responses
- intelligle verbalization
- movements or affective behaviors that occur in contingent relation to relevant environmental stimuli and are not attributed to reflexive activity
what % of people use to get misdiagnosed with VS
37-43%
criteria for emergence from MCS
- functional interactive communication via verbalization, writing, yes/no signaling, or use of augmentative communication devices OR
- functional use of 2 diff objects; behavioral evidence of object discrimination
JFK coma recovery scale (CRS-R) measures what
recovery from comatose through confusional states
aims to detect the subtle but potentially meaningful changes in the neurobehavioral fxn
how many scales does the JFK CRS-R have and what are they
arousal auditory visual motor oromotor communication
CRS-R level of responsiveness
no response tonic posture reflexive/automatic generalized localized purposeful
disorders of consciousness scale (DOCS)
bedside test measuring neurobehavioral functioning during coma recovery
evaluates a pt as they are brough through a series of test stimuli by modalities
what items are on the DOCS
social knowledge taste, swallow olfaction proprioceptive/vestibular tactile auditory visual object recognition, object tracking facial recognition, tracking
