Friday, February 4, 2011

The First Few Days

Your loved one has suffered a brain injury and is in a coma.  Here are some things you will need to know that will happen in the first few days.

Induced Hypothermia

As soon as possible following the resuscitation if necessary, induced hypothermia should be started.  The cooling of the body temperature to 93 degrees slows the damage caused by the bodies reaction to the brain injury.  The quicker the body temp is lowered the better.  As of this post, this is achieved by packing the patient in ice, infusing the body with cooled saline intravenously and with cooling blankets placed upon the patient.

This is the first of many "difficult to see" steps that are taken to help the patient recover.  Remember that what is important is what is best for your loved one, not how comfortable you are with what you are seeing.

The patient will shiver and will be cold to the touch.  It is the nurturing nature to want to rub their arms or perform other methods to warm them up.  Do not do this.  The body needs to cool.

Here are some medical studies that discuss this further.

You will be searching for any sign of hope regarding recovery.  Doctors and Nurses are there to follow the protocols that prove to be the most successful in assisting your loved one.  They must be very careful in offering anything that could turn to false hope.  We had a neurologist that stated the worst cases, the miracles and then showed us the MRI's and explained the severity of the damage to our daughters brain.  He did not offer any real hope.  He simply stated what he has experienced and what the facts were.  Do not get mad at the neurologist for seeming to be cold or uncaring.   Medical professionals at this stage are to stabilize your loved one and identify the extent of the damage. 

We found that our hope and strength came from our faith in Jesus Christ.

After about 48 hours, the neurologist will assess the coma status by using a scale called the Glasgow Coma Scale.  It is arrived at by summing the points from 3 categories.  Here is the scale:

Summing up the score will give you a total between 3 and 15.  This is used for deciding your loved one's state in ICU.  It is NOT a tool or point system to be used for anticipated levels of recovery.  Anyone that tells you that "after 72 hours, you pretty much get what you see" is not at all correct.  There are many cases where there has been high levels of recovery from very low to bottom Glasgow scores.

Your loved one will be susceptible to many infections.   Keep in mind that the hospital is the dirtiest place to be when you are injured.  There are many bacteria about that are not in your home.  Be extremely careful and "foam in, foam out"  with the disinfectant hand wash.  If you or anyone has a symptom of a cold, stay away.  It could be very hazardous at this stage.  Many will want to come and visit.  Though you should meet people, do so in the waiting room.  The fewer folks around your loved one during the first week or so, the better.  This is solely for protection against introducing a virus or bacteria into your loved one.  Be careful with who you meet and greet.  Be very cautious about spreading a germ.

You might wish to have some of the following with you during the first 3 days.  Chances are you will not be leaving much.

Cash (most cafe's are not open all the time at the Hospital)
Cell phone and charger
book (preferably the Bible.)
Snacks and lots of them.
Water - Keep yourself hydrated.
Portable music player to stimulate patient.

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