Podcast
Questions and Answers
What is the primary goal of serial neurobehavioral assessment by the interprofessional team?
What is the primary goal of serial neurobehavioral assessment by the interprofessional team?
What is the primary benefit of involving the interprofessional team in serial neurobehavioral assessment?
What is the primary benefit of involving the interprofessional team in serial neurobehavioral assessment?
What is the primary purpose of arousal facilitation before assessment?
What is the primary purpose of arousal facilitation before assessment?
What is the significance of visual pursuit as a marker of consciousness?
What is the significance of visual pursuit as a marker of consciousness?
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What is the primary limitation of standardized neurobehavioral assessments, such as the JFK-Coma Recovery Scale - Revised?
What is the primary limitation of standardized neurobehavioral assessments, such as the JFK-Coma Recovery Scale - Revised?
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What is the purpose of observing baseline behaviors for one minute prior to beginning assessment of arousal?
What is the purpose of observing baseline behaviors for one minute prior to beginning assessment of arousal?
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What is the primary goal of using multiple examiners in assessing patients with disorders of consciousness?
What is the primary goal of using multiple examiners in assessing patients with disorders of consciousness?
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Study Notes
Best Practices for Serial Neurobehavioral Assessment in Disorders of Consciousness (DoC)
- Serial neurobehavioral assessment by the interprofessional team is the best-practice, evidence-based guideline for evaluation of people with disorders of consciousness (DoC)
- Importance of arousal facilitation and addressing common confounders as a precursor to assessment
- Environmental and manual techniques necessary to implement prior to attempting to facilitate arousal
- At least 3 techniques used to facilitate arousal prior to beginning neurobehavioral examination
- Optimal facilitation of arousal prior to assessment involves specific environmental and manual techniques
Environmental and Manual Techniques
- Implementation of environmental conditions and manual techniques before and during assessment
- Importance of addressing common confounders to ensure accurate assessment
Evidence-based Assessment Tools in Disorders of Consciousness (DoC)
- Guiding principles of multiple evaluations over time, different modes of assessment, and multiple examiners
- Importance of evaluating under optimal conditions and minimizing confounders
- Evaluation performed at varying times of day to capture accurate responses
- Observing baseline behaviors for one minute prior to beginning assessment of arousal
- Visual pursuit as a marker of consciousness
Standardized Neurobehavioral Assessments
- JFK-Coma Recovery Scale - Revised
- Evidence: supports the use of this assessment tool
- Pros: effective in assessing consciousness
- Cons: may not capture all aspects of consciousness
- SECONDS
- Evidence: supports the use of this assessment tool
- Pros: effective in assessing consciousness
- Cons: may not capture all aspects of consciousness
- DOCS-25
- Evidence: supports the use of this assessment tool
- Pros: effective in assessing consciousness
- Cons: may not capture all aspects of consciousness
Limitations of Neurobehavioral Assessments
- Downsides of all neurobehavioral assessments on capturing "Covert Consciousness" (i.e., consciousness with severe disconnect to motor functions such as in locked-in syndrome)
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Description
This quiz covers the best-practice guidelines for evaluating people with disorders of consciousness, including environmental conditions and manual techniques for facilitating arousal. It's essential for healthcare professionals working in interprofessional teams.
