Distúrbios da Consciência Humana – Parte 2 de 3

Mendes, Plínio Duarte; Maciel, Marina; Brandão, Marcus; Fernandes, Paulo; Esperidião-Antonio, Vanderson; Kodaira, Sérgio Keidi; Siqueira-Batista, Rodrigo

doi:10.4181/rnc.2012.20.67402.8p

Cited by 3 publications

(6 citation statements)

References 16 publications

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“…Glasgow coma scale (GCS), developed by Taesdale and Jennet in 1974 at The University of Glasgow, Scotland, UK, is employed worldwide to identify neurologic dysfunction and follow-up progress of level of consciousness, predict prognosis, and standardize communication among health professionals. ( 6 ) This scale became an important tool to assist patient who suffered trauma, mainly BTI victims, and, posteriorly, its use extended to other neurologic conditions that can alter consciousness. Total score ranges from 3 to 15 and it is obtained by observation of spontaneous activities and use of verbal and/or painful stimulus.…”

Section: Introductionmentioning

confidence: 99%

Assessment of nurse’s knowledge about Glasgow coma scale at a university hospital

Santos

Campanharo

Lopes

et al. 2016

Einstein (São Paulo)

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Objective To assess knowledge of nurses of emergency services and intensive care units about Glasgow Coma Scale.Methods This cross-sectional analytical study included 127 nurses of critical units of an university hospital. We used structured interview with 12 questions to evaluate their knowledge about the scale. Association of Knowledge with professionals’ sociodemographic variables were verified by the Fisher-test, χ2 and likelihood ratio.Results Most of participants were women mean aged 31.1 years, they had graduated more than 5 years previously, and had 1 to 3 years of work experience. In the assessment of best score possible for Glasgow scale (question 3) nurses who had graduate more than 5 years ago presented a lower percentage success rate (p=0.0476). However, in the question 7, which evaluated what interval of the scale indicated moderate severity of brain trauma injury, those with more years of experience had higher percentage of correct answers (p=0.0251). In addition, nurses from emergency service had more correct answers than nurses from intensive care unit (p=0.0143) in the same question. Nurses graduated for more than 5 years ago had a lower percentage of correct answers in question 7 (p=0.0161). Nurses with more work experience had a better score (p=0.0119) to identify how assessment of motor response should be started.Conclusion Number of year since graduation, experience, and work at critical care units interfered in nurses’ knowledge about the scale, which indicates the need of training.

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Section: Introductionmentioning

confidence: 99%

Assessment of nurse’s knowledge about Glasgow coma scale at a university hospital

Santos

Campanharo

Lopes

et al. 2016

Einstein (São Paulo)

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“…Paroxysmal sympathetic and muscular hyperactivity after TBI, first described in 1929 by Penfield, is called dysautonomia (8,9). This culminates with increased heart rate and respiration, increased temperature and blood pressure, sweating and muscle modifications such as dystonia, stiffness, spasticity and posture such as flexion of the upper limbs and extension of the lower limbs (decortication) and extension of the upper and lower limbs (decerebration) (8)(9)(10).…”

Section: Disautonomymentioning

confidence: 99%

Cerebral dysautonomy as a clinical repercussion in children with traumatic brain injury

Silva¹,

Pereira²,

Rabelo³

2020

archpedneurosurg

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Introduction: Dysautonomia or Paroxysmal Sympathetic Hyperactivity (PSH) affects more than 50% of patients suffering from severe traumatic brain injury (TBI), which is a major cause of morbidity and mortality in children under 12 years. The goal is to demonstrate that PSH is established as a consequence in children with severe brain trauma. Methodology: Forty articles were found in databases such as LILACS, Elsevier and Scielo that address the theme, excluding those that addressed the TBI in adults and including those that addressed the theme in the pediatric context and published about the PSH, published until the year of 2019. Results: Severe TBI is established as a common cause of hospitalization of children and PSH as a common consequence. Diagnosis and management of this complication require the help of tools such as "PSH-Assessment Measure (PSH-AM)", which has criteria that facilitate the exclusion of other possible causes and guide the treatment. Non-pharmacological therapeutic measures include control of room temperature and low sensory and pharmacological stimuli to deal with symptoms, such as drugs such as opioids, gabaergic agonists, benzodiazepines and adrenergic antagonists. Conclusion: Severe TBI, a common pediatric emergency, can be considered a predictor of PSH. Even though there is no consensus on the diagnosis, PSH-AM proves to be a reliable alternative to professionals dealing with conditions that may or may not correspond with post trauma dysautonomia. This makes it possible to determine not only the child's clinical condition but also the best therapy to apply.

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“…In the absence of full decision-making ability on the part of the individual -in the case, for example, of a patient in a coma 49 -it is possible to make use of advance directives of will, an instrument that guarantees the right of a person to decide in advance, both negatively or positively, about the healthcare that he or she may receive in the future. It is the expression of will, indicated in advance, based on the principle of respect for autonomy.…”

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confidence: 99%

“…Therefore the practical reason for essentially concerning oneself with an action which can be considered moral corresponds to the virtuous character of the citizen, as well as the praxis of this agent 53,54 . Indeed, both theoretical (descriptive and understanding) and practical reason (applied) are indispensable tools of bioethics, in that the first allows assessment of the cognitive quality and logic of moral reasoning, while the second defines the moral quality of actions legitimized by such reasoning, by weighing the actual or likely consequences and by the morality of the agent 11,49 . Therefore, as theoretical bioethical tools, the rationality and reasonableness of arguments, which, being classified as rational, must be clear about the terms being used, as well as their limits and scope.…”

mentioning

confidence: 99%

“…Therefore, as theoretical bioethical tools, the rationality and reasonableness of arguments, which, being classified as rational, must be clear about the terms being used, as well as their limits and scope. They should also relate in an understandable way premises with the reasoning and the conclusion of the argument, ensuring that all participants have access to the communication of the moral question presented 49 .…”

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Processo de tomada de decisão nos cuidados de fim de vida

2015

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This study discusses ethical issues related to decisions about end-of-life care. The decision making process in clinical bioethics was selected as a basis for the study. Additionally, criteria for assessing and adopting positions on end-of-life issues were analyzed, including the necessity of including (or their substitutes), family members and healthcare practitioners in the decision making-process, in an atmosphere where respect for autonomy -with all its nuances and limitations -plays a key role. Keywords: Bioethics. Decision making. Ethics. Terminal care. Medical care. Palliative care. Resumo Processo de tomada de decisão nos cuidados de fim de vidaO presente trabalho discute questões éticas atinentes à tomada de decisão no contexto dos cuidados de fim de vida. Elegeu-se o processo decisório em bioética clínica para tal propósito. Analisam-se, ainda, critérios para a deliberação e o posicionamento ante os problemas relacionados ao fim da vida -os quais devem envolver enfermos (ou seus representantes legais), familiares e profissionais da saúde -, em um âmbito no qual o respeito à autonomia, com todas as suas nuances e limitações, tenha lugar de destaque. Palavras-chave: Bioética. Tomada de decisões. Ética. Assistência terminal. Cuidados médicos. Cuidados paliativos. Resumen Proceso de toma de decisión en los cuidados de fin de vidaEste texto habla de cuestiones éticas relacionadas con la toma de decisiones, dentro del contexto del cuidado de final de vida. El proceso de toma de decisiones en bioética clínica fue seleccionado para este fin. Se analizan, además, criterios para tasar y adoptar posturas en cuestiones de final de vida -los cuales deben implicar a los enfermos (o sus representantes legales), familiares y profesionales de la salud -, en una atmósfera en que el respeto a la autonomía, con todos sus matices y limitaciones, desempeña un papel fundamental. Palabras-clave: Bioética. Toma de decisiones. Ética. Cuidado terminal. Atención médica. Cuidados paliativos.

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Distúrbios da Consciência Humana – Parte 2 de 3

Cited by 3 publications

References 16 publications

Assessment of nurse’s knowledge about Glasgow coma scale at a university hospital

Assessment of nurse’s knowledge about Glasgow coma scale at a university hospital

Cerebral dysautonomy as a clinical repercussion in children with traumatic brain injury

Processo de tomada de decisão nos cuidados de fim de vida

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