...by medical staff and machinery. Melissa has brain death and will no longer be able to be herself ever again she is accentually dead, as the Melissa you know died the minute her Cortex was damaged and her neurons stopped producing electrical currents. This patient is only breathing and her heart beating because the reptilian part of the base of the brain is still sending out life supporting neurons to keep these basic functions going. This is not to be mistaken for a coma,if she was lucky enough to endure this kind of brain damage, she may be able to stay alive and regain some of her traits that make up who Melissa is. There are no guarantees that if Melissa did fall into a coma that she will wake up and be functioning again. A coma is a prolonged state of unconsciousness. During a coma, a person is unresponsive to his or her environment. The person is alive and looks like he or she is sleeping. However, unlike in a deep sleep, the person cannot be awakened by any stimulation, including pain.The prognosis for a coma varies with each situation. The...
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...stopping of the heart and cessation of breathing” (Fins and Laureys 1). However, with the advent of the artificial ventilator invented by Bjorn Ibsen from Denmark, a patient’s breathing and heartbeat could be continued, even in the absence of brain function (Fins and Laureys 1). Once physicians diagnose a patient as brain dead, the next step is often the procedure of organ transplantation. There is a multiplicity of views on brain death and subsequent organ transplantation, with each culture’s beliefs shaping its own medical practices; these differing stances often lead to ethical debates. Background Brain death was first described in the 1950s by two French physicians, Mollart and Goulon, who termed it as “coma depasse,” a state beyond coma and differentiated it from “coma prolonged,” a continual vegetative state (Ganapathi 10). The Harvard Ad Hoc Committee later reported two definitions of death: the “traditional” cardio-pulmonary death and “brain death” (Lock 138). In 1981, the Report of the Medical Consultants on the Diagnosis of Death to the US President's Commission reevaluated death, advocating that the diagnosis of brain death should not be distinguished from the death of “the organism as a whole” (Death, dying and donation 9). Over the years, medical personnel have come to view brain death as the death of the brain stem, and diagnose it by examining the function of nerves that originate in the brain stem (Death, dying and donation 10). Further, there is no “golden rule”...
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...ASB 353 Chapter 5 1/5 of Americans are home when they die, over 30% die in nursing homes, and 50% die in hospitals. Three major categories of institutional medical care * Hospital are devoted mainly to acute intensive care of a limited duration. * Nursing homes provide long-term residential care for people who are chronically ill and those whose illness does not require acute, intensive care. * Hospice care is distinguished by its orientation toward the needs of dying patients and their families Rationing-refers to the allocation of scarce resources among competing individuals. In health care it is defined as any system that limits the amount of health care a person can receive. Paternalism- the assumption of parent like authority by medical practitioners, is seen as infringing on a patient’s autonomy or freedom to make medical decisions. Covenantal relationship- which implies a mutuality of interest between provider and patients. Eight principles that are important when delivering bad news 1. Keep it simple 2. Ask yourself, “What does this diagnosis mean to the patient?” 3. Meet on “cool ground” first. Get to know a patient prior to presenting the news. 4. Wait for questions. 5. Do not argue with denial. 6. Ask questions yourself. 7. Do not destroy all hope. 8. Do not say anything that is untrue. Strategies that either curtail or encourage conversation when speaking of death by a caregiver * Reassurance * Denial ...
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...When a person is born it is an immediately known that one day they will die. You go through life carefree not considering that one day that could instantly change. Often times persons of a particularly older age tend to have measure in place that dictates their final wishes such as wills, DNRs, and their desire to donate organs or not. At twenty or even thirty you aren’t considering your demise. The most you may have is life insurance. If something happens that daunting task is often left to your loved ones. Hospitals are faced with the grueling task of ethically ensure their duty to do no harm while also trying to respect the patients and loved ones wishes. When it comes to traumatic unforeseen brain injuries it can be hard to let go. One day the person was perfectly normal, then instantly you are faced with deciding how they will ultimately spend their last living moments. You must consider the how the person’s life was before the injury as well as the quality of life they would have if treatment was continued. A patient’s death dictates a cease of treatment and allows those who have made their wishes known can begin the process for donating organs for transplantation to help save the life of others. A determination between life and death is essential due to the physician’s inability to waste limited medical resources or to potentially violating medical ethics by inflicting treatment after the patient is considered medically dead. With a precise diagnosis, families may be...
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...which caused her to suffer from extreme hypokalemia, which is an imbalance of potassium. The hypokalemia caused the cardiac arrest, which led to a coma due to anoxia, a lack of oxygen in her brain. Terri had brain damage and was in a vegetative state “ during the subsequent months, she exhibited no evidence of higher cortical function. Computed tomographic scans of her brain eventually showed severe atrophy of her cerebral hemispheres, and her electroencephalograms were flat, indicating no functional activity of the cerebral cortex. Her neurologic examinations were indicative of a persistent vegetative state, which includes periods of wakefulness alternating with sleep, some reflexive responses to light and noise, and some basic gag and swallowing responses, but no signs of emotion, willful activity, or cognition” (Quill, M.D., 2005) At the hospital to buy time and keep her alive doctors had inserted a feeding tube. Two months later, her husband Michael transferred Terri from the hospital to a rehabilitation center. The following month her husband with no objections from her parents became her legal guardian. Her parents tried taking her home and caring for her but later sent her back to the rehab center because it was too much work to take care of her at home. Terri needed round the clock care “For months 13-18 into her coma, three shift of workers worked 24 hours a day trying to rehabilitate Terri” (Pence, 2011) For five years, Terri received intensive rehabilitation...
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...couldn’t wake up from all started the day Debra was born. She was “The Devil’s Daughter” as her schizophrenic mother called her. Debra’s mother sexually abused herself as a child, and then began to abuse her Debra at birth, putting her crib in a confining closet at the back of the house. She was convinced that her newborn daughter Debra was going to destroy her marriage and would end up having sex with her husband. Debra, being the oldest daughter, took the full brunt of her Mother’s abuse, although younger sister Danielle was also badly mistreated when she was born. They were both routinely subjected to deprivation and homicidal rage, yet Debra was her Mother’s main target. Within days of being force fed adult sedatives, Debra fell into a coma, losing sensory perceptions. Her Father found her on the floor of her closet reeking of urine and feces in a comatose state. She was rushed to Children’s Hospital in St. Louis, where she spent several weeks recovering from her Mother-inflicted drug overdose. The overdose was reported to social services, which finally stepped in and took serious action against the family, telling them that Debra would be placed in a home in southern Missouri for a year until the family decided whether or not they wanted her or could take care of her. Debra eventually was returned to her family after her one year stay at a foster home and the abuse continued the day after she arrived back...
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...every now and then. It gets dangerous when people mix it with other substances. And that’s exactly what Karen Quinlan did when she was only 17 years old. She mixed alcohol and valium. This bad combination put her in a persistent vegetative state. After fighting the New Jersey’s Supreme Court for over ten years, her parents were finally able to remove all artificial forms of life and allow her to die with dignity at the age of 31 years old. Karen Quinlan is the symbol of the right to die. A coma or a terminal illness can come anytime. And this is going to affect us even though we feel that at this age it cannot. You must be ready to deal with these instances and know exactly where you stand when it comes to life and death. Today I’d like to discuss the difference between being alive and living. Explain more about the right to choose. And expose the necessity of having a living will. In 1983, Paul suffered a brain aneurism. His brain dissipated in swelled, forcing him to a persistent coma. For 3 and a half year he remained in this state. At the beginning, friends and family members came to visit but after a few years, people stopped asking about him, people stopped to visit him so his wife, Patricia, knew that something had to be done. The doctors refused to remove his feeding tubes. Therefore she created a petition to end his life. But the pro life supporters argued that she was abusive and cruel, inhumane and no better than Nazi murderers. So, in that case, my question...
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...yourself, doesn’t that sound familiar? The feeling of paranoia and anxiety seeping through your heart with every beat as your life takes a wrong turn. Your feelings constricted, the exact way your soul is when deciding to listen your heart or your head. There are times when listening to your head will suffice when compared to what’s being said in your heart. Persistence comes to mind; your “diving bell becomes less oppressive, and your mind takes flight like a butterfly.” You are what you eat; the same mentality is embedded in life. You are what you experience and experience builds character. Take a look at everyone who has succeeded in life, would they be where they are at if they simply chose to give up? “I myself had twenty days of deep coma […] before I truly appreciated the extent of the damage.” Without ups and downs, your life would be like a broken ECG machine. There wouldn’t be any signs of improvement as time passes by. The author is in agony, but it...
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...The Main purpose of this case summary asked by our CEO Felicia Larue is to give a brief on the patient situation and to ensure that her rights of are preserved and the risks to the hospital are minimized. Been paralyzed refers to patients that needs the use of the latest available procedures for psychotherapeutic work, comatose and treatment for different states of consciousness. Patients in comatose states like Lydia have been traditionally considered as victims of neural pathological procedures that overcome cognitive and communicative functionalities. While the latest procedures on spinal cord injuries suggest that patients may display spaces of consciousness on the worst persistent vegetative states. Is very common that disputes arise over the treatment of patients that had been unresponsive through injury or illness for certain time lapse. Families get torn between the final decision because for some to end the “artificial life” is the alternative to stop the “suffering”. Cases such as Terri Schiavo can last years on court on a back and forth demand. Medical examination reveals apparently irreversible brain damage in a persistent vegetative state since 1990. Her husband and her family went to court battle to decide if the feeding tube should be removed. Finally her husband prevailed in court on 2005 and Schiavo died in March 2005.Others with firm beliefs wait for the miracle. Doctors in England and Belgium (Owen et al., 2005) found signs of life in a “damage” brain of...
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...classical music which lead to her applying to Juilliard. One snow day, Mia’s family decides to take a drive to their grandparent’s house for the day. The roads are very slippery which causes a huge car crash killing Mia’s family instantly. When emergency help arrives, Mia is still alive. She is rushed to the hospital in a deep state of a coma. Her body is left in a sleep-like state but her mind is still aware of her surroundings causing her to walk around without anyone seeing her. Throughout the novel, Mia recalls many memories of her life before the crash which helps her to choose to leave or stay. If I Stay is a good novel because it contains well-developed characters, themes that are relatable, and several interesting incidents that influence the outcome of the novel. One of the elements that made this novel memorable is the well- developed characters. In If I Stay, Mia is a hardworking cellist in a rock-n-roll family. She had everything a normal teenage girl would have: a loving family, and adoring boyfriend, and a future full of success for the future in music. But, a tragic crash turns Mia’s normal existence upside down. She is left in a coma state that lets her spirit self walk around the hospital while her body is left in the ICU. She discovers that she has to choose whether to stay with her boyfriend and friends or leave with her deceased family. Throughout the novel Mia has to remember happy memories to help her choose. Most of her memories are happy times with her boyfriend...
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...Matt Physical Assessment Narrative November 22, 2014 Client resting in semi-fowlers position. Hand hygiene performed and verification of client by two identifiers (Name, DOB) are matched with I.D. band to confirm client. Client assessed for allergies and concerns and reports no concerns or allergies. Client is Ox3, LOC is alert, shows PERRLA, and EOMS intact in all fields. Glascow Coma Scale assessed to be a perfect 15. Client grips are 5/5 (B) in hands and feet. Homans sign neg, and no bruising, scars, lesions, ulcers, edema noted. Skin is warm and dry and mucous membranes appear pink and moist. Client has intermittent IV in left antecubital region with no fluid intake and client asked if he had anything to drink within last couple hours and he states “I’ve had a 12oz coke” (I said mL in video and meant to say Oz). Intake documented to be 360mL. Client voids using BSC. 200mL of clear, amber urine present in BSC and documented as output. Radial and pedal pulses are palpated and found to be 2+ (B). Client asked about diet and he states he is on a regular diet. Heart sounds auscultated without extra heart sounds and apical pulse assessed to be 66 regular. Respiration rate of 16 with eupneic pattern. Bowel sounds auscultated to be normoactive in all 4 quads. Lungs clear to auscultation in all 5 fields A-P-L. Client wears no corrected lenses/glasses, or hearing aids and no drainage from eyes or ears are noted. ROM full in all areas and gait appears to be steady. IV site appears...
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...Comas have been a major mystery in medical history. In recent years the research into comas has helped many people in the medical field care for and understand what exactly comas entel. Comas are a long journey but there are chances of recovery and living a healthy life. A coma is defined as a profound or deep state of unconsciousness. There are many causes for comas. These can include traumatic brain injury, swelling, bleeding, stroke, lack of oxygen, diabetes, infection, and toxic exposure. The most common symptom for a coma is trauma. This could be either a closed or open head injury which usually causes the brain stem to be damaged (“Traumatic”). People who are in a coma are unconscious and they cannot be woken up by touch...
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...Quantitative Critique: GCS and Later Cerebral Atrophy in Pediatric TBI Sofia Soqui Grand Canyon Univserity Introduction The Glasgow Coma Scale (GCS) is the most common scoring system used to describe the level of consciousness in a person a traumatic brain injury (TBI). This scale does have its limitations when it comes to its use in pediatrics, but it continues to be a great method of estimating severity of TBI. There now is a pediatric version of the GCS that has been altered to accommodate the different ages in children (Pediatric Care Online). This article performed a study to see if there is any correlation between a pediatric patients GCS score and later cerebral atrophy after a traumatic brain injury. Protection of Human Participants In the article the authors do not address any risks or benefits that may come from participating in this study. There were no risks that I could identify from reading the article, as participants were to only receive a quantitative magnetic resonance image (QMRI) approximately four months after a TBI. I also do no think that there is anything beneficial for the patient from this research study, as it seems that the final results will benefit future TBI victims in determining if they will be faced cerebral atrophy. There was no mention in the article about informed consent, but no personal information was disclosed in the article. The authors did not mention if there was an approval by an institutional review board. The only patient...
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