TBI Flashcards
Describe 4 clinical signs of a TBI
period of loss/decreased consciousness
loss of memory
neuro deficits
slowed thinking, confusion
what is ranchos los amigos scale used for?
measure awareness, cog, behavior
What is normal ICP?
17-15mm of mercury
Descrie EVD
done bedside, catheter placed in ventricles to drain CSF, Must ask nurse to clamp before working
Craniotomy vs craniectomy
iotomy: put skull back in immediately
iectomy: remove skull/blood place in stomach for healing
when working with patients level 7-10 what are some cognitive intervention?
problem solving training, verbal self instruction,
when should you use metacognitive training approache?
when patients have emergent awareness anticipatory awareness (usually level 8)
what type of approach would you use with level 7-10pts
multicontextual approach: checklist, audio reminder, mental rehearsal
CO-OP
when using metacognitive training what type of awareness does one might need?
emergent or higher- know they have a problem while its happening
What type of awareness does one must have to use CO-OP?
emergent and anticipatory
What are the key features of CO-OP?
client centered, dynamic performance analysis, cog strategy, guided discovery, enable principles
Describe a rancho 4
alert with heightened activity
purposeful attempt to remove tubes
short attention span
no new learning
What can OT do for a patient level 4 rancho?
help them feel comfortable in their enviornment, keep enviornment quiet, structure tasks, incorporate frequent breaks, familiar objects
Describe a patient level 5 rancho
very distractible
no new learning
oriented to self
no problem solving
may be agitated with overstimulation
OT considerations during treatment with level 5
repeat things, questions should be simple, routine/automatic overlearned activities, simple commands
Describe rancho level 6
inconsistent orientation, poor awareness, attent to familiar tasks for 30min
emerging awareness
demonstrate carry over
OT intervention considerations for level 6 rancho
encourage note taking, new learning, orientation questions, ADLs, task modifications
What does GCS look at?
eye opening, motor responses, verbal responses
What is a high score for GCS and what does that mean?
15- oriented x3, follows commands, opens eyes
What is a low GCS score and what does that mean?
3
no response, no response to stimuli, does not open eyes
What does someone typically look like at rancho level 1
no eye opening, no movement, no response to commands/tactile/auditory
Describe RLA 2
total assist,
describe RLA 3
follows commands, gestural or verbal yes/no, purposeful movements, turns away/toward stimuli
describe OT role in RLA 3
wheel chair position, manage dysphagia, emotional/behavioral, family/caregiver edu
