OME - Coma Flashcards Preview

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Flashcards in OME - Coma Deck (12)
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1
Q

What is seen in coma?

A
  1. Cerebral function - depressed
  2. Brainstem - Normal
  3. CV - Normal
  4. Motor - Normal
2
Q

Coma cocktail?

A
  1. Naloxone
  2. Thiamine
  3. D50
3
Q

How to determine cerebral function is active?

A

Get an EEG

4
Q

What is seen in persistent vegetative state?

A
  1. Cerebral function - None
  2. Brainstem - Normal
  3. CV - Normal
  4. Motor - Intact
5
Q

What is seen in brain death?

A
  1. Cerebral function - none
  2. Brainstem - None
  3. Heart - Beating
  4. Motor - None
6
Q

What happens when take brain dead patient off vent?

A
  1. Stop breathing

2. Heart will still continue to beat

7
Q

What is brain death?

A

Absence of brainstem reflexes

- Must be determined by 2 or more Docs at same time

8
Q

What are the brainstem reflexes you are checking?

A
  1. Corneal
  2. Cold water calorics
  3. Dolls eyes
9
Q

How to check corneal reflex?

A

Touch eyeball with qtip and nothing happens

10
Q

How to test cold water calorics?

A
"COWS": Cold, opposite. Warm, same. 
- Refers to nystagmus 
Cold water in ear if alive:
1. Eyes move towards ear
2. Nystagmus moves away
Cold water in ear if cerebrum dead:
1. Eyes move towards water 
2. No nystagmus 
Cold water if brain stem dead:
1. Eyes do not move at all
11
Q

How to test dolls eyes?

A
  1. If stem intact, eyes move conjugately away from direction of turning (as if still looking at the examiner rather than fixed straight ahead)
  2. Negative “doll’s eyes” would stay fixed (move with head as turned) sign patient brainstem is functionally not intact.
12
Q

Pathology locked in syndrome?

A
  1. Pontine stroke
  2. Patient 100% alive and aware
  3. Can feel, but cannot move
    4 Can only communicate with eye blinks