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Disorders Of Consciousness

WHAT YOU SHOULD KNOW:

Disorders Of Consciousness (Discharge Care) Care Guide

  • Disorders of consciousness (KON-shus-nes) are conditions where the state of awareness or wakefulness is disturbed. Consciousness is normally controlled by different parts of the brain. These systems keep a person alert and aware of himself and his environment. Disorders of consciousness may include coma, vegetative state, minimally conscious state, akinetic mutism, and delirium. These may be caused by head trauma or conditions causing a decreased oxygen supply in the brain. Certain medicines, drugs, and alcohol may also have effects on the brain and may affect consciousness.

  • Signs and symptoms will depend on how bad the patient's consciousness is affected. As time passes, the patient may shift from one state of consciousness to another. Other signs and symptoms may also be present pointing to the cause of the condition. A detailed health history of the patient and a complete physical exam is needed to diagnose a disorder of consciousness. Blood tests, urine tests, and different imaging tests may also be needed. Treatment will depend on the cause of the disorder of consciousness. This may include medicines and other measures to support the patient. With treatment and care, further problems may be prevented.

AFTER YOU LEAVE:

Medicines:

  • Keep a written list of the medicines to take, the amounts, and when and why they are given. Bring the list of these medicines or the pill bottles when you see his caregivers. Do not give the patient any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to his caregivers.

  • Always give the medicine as directed by the patient's caregivers. Call his caregivers if you think the medicines are not helping or giving him side effects. Do not stop giving the medicines until you discuss it with the patient's caregiver.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Respiratory care:

  • Chest physiotherapy: This is also called CPT. It is used to loosen up the sputum (mucus) in the lungs and help the patient breathe easier. CPT is done by tapping over the patient's ribs (chest, back, and side). Once the fluid is loosened, the patient may need to cough it up. If he cannot cough it up, suction may be used to remove it.

  • Deep breathing and coughing: If possible, have the patient breathe deeply and cough. Deep breathing opens the tubes going to the lungs. Coughing helps to bring up sputum from the lungs to be spit out. An incentive spirometer may be used to help the patient take deeper breaths.

  • Suction: A small tube is used to help suck out the mucus in the patient's mouth, nose, and lungs. This tube will be inserted in the mouth or nose. Suction may need to be done more than once to make sure all of the mucus is out.

Skin care:

A special mattress called an egg crate or air mattress may be put on the patient's bed. The patient will need to be turned often if he cannot move by himself. Turning often will keep him from getting bed sores.

Therapy:

A physical therapist and an occupational therapist may exercise the patient's arms, legs, and hands. They may also teach new ways to do things around the house. A speech therapist may work with the patient to help him talk or swallow.

CONTACT A CAREGIVER IF:

  • The patient has a high body temperature.

  • The patient develops new symptoms.

  • You are having trouble with any of the patient's exercises.

  • You see a pressure sore on the patient's skin.

  • You have questions or concerns about the patient's condition, medicine, or care.

SEEK CARE IMMEDIATELY IF:

  • The patient's blood pressure is higher than his caregiver suggests.

  • The patient has trouble breathing.

  • The patient is sweating a lot.

  • The patient's lips or fingernails turn blue or white in color.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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