Summarizes pharmacological responses to agitation among people who are in an intensive care setting. Discusses antipsychotic, neuroleptic, opioid, benzodiazepine, paralyzing, sedative, and antidepressant agents, as well as propofol.
Describes the case of a 38-year-old male with traumatic brain injury (TBI) resulting from a fall (initial Glasgow Coma Scale rating 12). A central venous catheter was placed to help manage associated chest and abdominal injuries. The agitated patient twisted off several hubs from the central venous catheter with ...
Reviews studies examining the usefulness of acute and subacute parameters for predicting specific functional outcomes for patients with traumatic brain injuries (TBI) who are slow to respond. Discusses the parameters most pertinent to specific outcomes in TBI patients with coma.
Study examining the demographics and functional outcomes of persons who require inpatient rehabilitation for severe penetrating head injury resulting from a gunshot wound to the head. Data were collected prospectively for 27 individuals with severe penetrating head injuries at a trauma center and a rehabilitation hospital traumatic brain injury ...
Primary objective: To examine the relationship between CT abnormalities and early neuropsychological outcome following traumatic brain injury (TBI) using quantitative CT analyses, data reduction methods for neuropsychological results and specific hypotheses based on literature review. Research design: Observational, prospective cohort study using acute (emergency) CT data and neuropsychological test ...
Traumatic injury is a relatively common occurrence, with approximately 40 million injury-related visits to emergency departments in the United States per year. Psychiatric complications of physical injury are a public health concern. Approximately 12% to 16% of survivors of traumatic injury are diagnosed with acute stress disorder (ASD), and ...
Objective: Compare white and African American caregivers of people with moderate to severe traumatic brain injury (TBI) regarding caregiving patterns, emotional function and life satisfaction, and preferred supports. Design: Prospective, observational study; 1, 2, or 5 years post-TBI. Setting: Six TBI model systems. Participants: Two hundred fifty-six caregivers (195 ...
This paper deals with the issue of fitness to drive in patients suffering from traumatic brain injury (TBI). Guidelines for assessment are proposed and three types of studies are reviewed: studies about impairments of attention and information processing, studies of driving competence, and driver selection studies, applying and evaluating ...
Objective: To examine the relations among driving status, perceptions of barriers to the resumption of driving, and community integration outcomes after traumatic brain injury (TBI). Design: Correlational research using logistic and multiple regression analyses, analyses of variance, and covariance. Participants: Fifty-one survivors of TBI, 6 months to 10 years ...
Objective: To examine the properties of the Rehabilitation Therapy Engagement Scale (RTES), a new scale developed to assess patient engagement in physical and occupational therapies in the acute rehabilitation setting quantitatively. Design: Psychometric analysis to test the reliability and validity of the RTES in a Midwestern acute rehabilitation facility. ...
The influence of circadian preference was examined among 56 morning-oriented rehabilitation inpatients with cognitive (n ¼ 28) and noncognitive (n ¼ 28) impairments. Each individual was tested twice: morning (preferred time) and evening (nonpreferred time); sessions and test batteries were counterbalanced to control for practice effects. Standard measures assessed ...
This archival study examined the effectiveness of using a normative floor effect method to detect suboptimal performance in a clinical sample of 120 cases consecutively referred for a neuropsychological evaluation. These cases were divided into moderate-severe TBI, mild TBI, and poor effort
litigants (demonstrating suboptimal effort). Percentiles, sensitivity, ...
The present study examined the influence of African American acculturation on the performance of neuropsychological tests following traumatic brain injury (TBI). Seventy one participants already enrolled in a larger-scale study assessing the impact of TBI (i.e., the South Eastern Michigan Traumatic Brain Injury Model Systems project) completed a self-report ...
Objective: To examine whether the Wide Range Achievement Test-3 (WRAT-3) Reading subtest (S. Jastak & G. S. Wilkenson, 1984; G. S. Wilkinson, 1993) measures premorbid intelligence in persons with traumatic brain injury (TBI). Participants: Sixty individuals (63% male, 78% Caucasian, mean age = 38 years) tested during acute rehabilitation ...
Social support is an important determinant of adjustment following traumatic brain injury (TBI) sustained by a family member. The present study examined the extent to which social support moderates the influence of characteristics of the person with injury on caregiver subjective well-being. Sixty pairs of individuals who had sustained ...
Objective: To identify the frequency and manifestations of depression after traumatic brain injury (TBI) and the factors that contribute to developing this mood disorder. Design: A prospective, nationwide, multicenter study; 17 centers supplied data from medical records and patient responses on a standardized criterion instrument. Setting: Traumatic Brain Injury ...
OBJECTIVES: To compare diagnostic and treatment-related differences between persons participating in treatment for dually diagnosed substance use disorders and severe mental illness who have or do not have a history of traumatic brain injury (TBI). DESIGN: Prospective cohort. INTERVENTIONS: Not applicable. PRIMARY MEASURES: Demographic information, diagnostic data, pre-treatment status, ...
Objective: To evaluate how demographics, measures of injury severity, and acute care complications relate to sitting and standing balance in patients with traumatic brain injury ( TBI ). Design: Multicenter analysis of consecutive admissions to designated TBI Model Systems of Care (TBIMS). Setting: Ten National Institute for Disability and ...
Purpose of review The burden of proof for establishing diagnosis and prognosis in patients with disorders of consciousness lies with behavioral assessment methods. The current review discusses recent advances in understanding the strengths and weaknesses of this methodology. Recent findings Behavioral assessment methods remain the ‘gold standard’ for establishing ...
Widespread loss of cerebral connectivity is assumed to underlie the failure of brain mechanisms that support communication and goal-directed behaviour following severe traumatic brain injury. Disorders of consciousness that persist for longer than 12 months after severe traumatic brain injury are generally considered to be immutable; no treatment has ...