Coma recovery score (revised) is used more prominently in the recovery literature which is validated in disorders of consciousness.
Carinal stimulation via suctioning rather than pain may be a more useful way of generating arousal.
Don’t say ‘squeeze my hands’ to assess commands – rather ‘give me (two) thumbs up’
Data from the IMPACT trials have been used to create a risk prediction model which is available online.
Prediction models for 6 month outcome after TBI
Alpha coma on EEG may have a poor prognosis but the cause is important to the outcome.
Etiology, neurologic correlations, and prognosis in alpha coma
Medial temporal lobe seizures may not be well detected on surface EEG
American Clinical Neurophysiology Society’s Standardized Critical Care EEG Terminology
Anti-N-methyl-D-aspartate receptor antibodies: A potentially treatable cause of encephalitis in the intensive care unit
The VIP approach for treating the unstable Patient: ventilate (oxygen!) – infuse (fluids!) – pump (drugs?) à VIP helps you to put together and never forget these very simple elements
SOSD for fluid administration – in which phase are we? : S (salvage) the unstable patient – give fluids; O (optimization) e.g., passive leg raising to further assess need for fluids; S (stabilization); D (de-escalation) e.g., diuretics?
Continue reading NEXT Debate: Decision-making under pressure. Beyond SOP