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How To Interact With A Loved One Who Is Unconscious Or At A Low Level Of Responsiveness

Brain dead woman can be taken off life support: judge

The most natural way of interacting is to talk to your loved one, even though he or she may not respond or understand. Telling him or her about recent events in your life, whats going on in your family or neighborhood, or the latest news may make you feel connected. Talking with your loved one about what you are doing as you provide care can increase your comfort with caregiving. For example, telling your loved one that you are going to move his or her arms and legs to help prevent joint tightness might make you feel more comfortable with this task. Only do these range of motion exercises if you have been instructed to do so by a doctor, nurse, or therapist.

Touch is another way to feel connected. Some family members have said that giving a massage or putting lotion on the hands or face of their loved one helps them to feel close to them. Its also important to give your loved one time for quiet and rest, such as by turning the TV off. You should also avoid overstimulation as this may cause rapid breathing, muscle tightening, teeth grinding, restlessness, and fatigue.

What Is Traumatic Brain Injury

Traumatic brain injury happens when a sudden, external, physical assault damages the brain. It is one of the most common causes of disability and death in adults. TBI is a broad term that describes a vast array of injuries that happen to the brain. The damage can be focal or diffuse . The severity of a brain injury can range from a mild concussion to a severe injury that results in coma or even death.

Case Of Jahi Mcmath Raises Questions About Brain Death

The right-to-life battle over a 13-year-old California girl declared brain dead last month has rekindled a national debate over whether a person in her state should be kept alive.

Jahi McMath underwent a tonsillectomy Dec. 9 at Childrens Hospital Oakland to treat her sleep apnea. She woke up after surgery but began bleeding, later going into cardiac arrest. She was put on life support and declared brain dead.

As Jahi remained on a ventilator in an undisclosed care facility on Monday, her case continues to raise burning questions about what it means to be brain dead and if there is life after brain death.

Is being brain dead the same as being dead?

Doctors can consider someone dead in two ways: the heart and respiratory system stop, or the brain loses all function.

There are a variety of tests that can be done to determine brain death, said Dr. Trevor Resnick, chief of neurology at Miami Childrens Hospital. Doctors see if the body responds to pain or if certain eye movements can be provoked. There are also brain wave tests that measure the brain’s electrical activity.

In Jahi’s case, because she was found brain dead, a coroner issued a death certificate with the date of death as Dec. 12. But without performing an autopsy, officials haven’t given an official cause of death.

Whats the difference between brain dead and a vegetative state?

How long does the body of a brain-dead person sustain itself?

Can their body still process food?

And would insurance cover it?

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What Research Is Ninds Funding

The mission of the National Institute on Neurological Disorders and Stroke is to seek fundamental knowledge about the brain and nervous system and use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.

NINDS supports research across the full range of TBI severity, in animal models and people, from children to adults. Projects focus on the mechanisms that result in immediate and delayed damage to the brain, on the processes that underlie recovery, and developing better diagnostic tools and more effective treatments.

Among NINDS research efforts:

In addition to NINDS, other NIH Institutes fund research on TBI. Research projects on TBI and other disorders can be found using NIH RePORTER , a searchable database of current and past research projects supported by NIH and other federal agencies. RePORTER also includes links to publications from these projects and other resources.

Taking Care Of Yourself And Other Family Members

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Family members of a person in the VS or the MCS often feel a sense of loss or grief for the relationship they had before the injury. You can cope with these feelings in a few ways. A person in the VS or the MCS may make slow progress or go for long periods with no progress. Keeping a journal of the changes you have seen may be comforting. This may let you see how your loved one is more able to respond than he or she was at an earlier point in time.

Having a loved one who is in the VS or the MCS can be physically and emotionally draining. Dealing with this alone can be too much for one person. Its important to rely on support from others. You can look to existing supports, such as family, friends, and religious groups. You can also find new supports.

Other resources to consider include support groups and agencies, and the internet. You can contact the Brain Injury Association of Americas National Brain Injury Information Center . The BIAA can give you contact information for the closest chapter of your state brain injury association. Health care providers such as doctors, therapists, and social workers may also be good sources of information about supports available to you

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How Science Found A Way To Help Coma Patients Communicate

After suffering serious brain injuries, Scott Routley spent 12 years in a vegetative state. But his family were convinced that he was still aware could a pioneering mind-reading technique prove them right? By Adrian Owen

On 20 December 1999, a young man pulled away in his car from his grandfathers house in Sarnia, Ontario, with his girlfriend in the passenger seat beside him. Scott Routley, who was 26, had studied physics at the University of Waterloo and had a promising career in robotics ahead of him. But at an intersection just a few blocks from his grandfathers house, a police car travelling to the scene of a crime crashed into the side of Scotts car, hitting the drivers side full on. The police officer and Scotts girlfriend were taken to the hospital with minor injuries. Scott wasnt so lucky his injuries were devastating.

I heard about Scott 12 years later, soon after arriving in London, Ontario, where I run a lab that studies acute brain injuries and neurodegenerative diseases. His family are convinced he is aware, but we have seen no signs of it, and weve been observing him for years! Scotts doctor told me.

Nevertheless, his family were adamant: Scott was responsive, and therefore Scott was aware.

As Scott lay in the fMRI scanner,my colleague, Davinia Fernández-Espejo, and I went through the routine we had developed for ascertaining if patients in the grey zone were conscious and aware of what we were saying to them.

How Much Should You Cry

Researchers at Tilburg University put crying under the microscope. Their results? On average, American women cry 3.5 times each month while American men cry around 1.9 times each month. The averages by country vary considerably. The average in America is on the higher end of the spectrum. Women in China, for example, only cry about 1.4 times each month. Men in Bulgaria reportedly cry a mere 0.3 times each month.

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What Are The Signs And Symptoms

Seek immediate medical attention if you experience any of the following physical, cognitive/behavioral, or sensory symptoms, especially within the first 24 hours after a TBI:

Physical

  • hearing problems, such as ringing in the ears
  • bad taste in the mouth
  • sensitivity to light or sound
  • mood changes or swings, agitation, combativeness, or other unusual behavior
  • feeling anxious or depressed
  • fatigue or drowsiness a lack of energy or motivation

Headache, dizziness, confusion, and fatigue tend to start immediately after an injury, but resolve over time. Emotional symptoms such as frustration and irritability tend to develop during recovery.

Scientists Grew Human Tear Ducts In A Lab And Taught Them To Cry

Baby Born 117 Days After Mother Is Declared Brain-Dead

18 March 2021

The glands had no openings so they swelled up like “balloons.”

Disembodied human tear glands, grown in petri dishes in a laboratory in the Netherlands, have the ability to cry and the scientists who created them have already grafted them into the eyes of living mice.

The series of experiments, detailed in a new study published online March 16 in the journal Cell Stem Cell, could represent a major step forward in the science of treating dry eye a condition that impacts about 5% of adults worldwide and can lead to blindness in severe cases.

Petri-dish body parts have become more commonplace in laboratory experiments, but they’re often much smaller and simpler than their natural counterparts. “Minibrains,” for example, are smooth, pea-size, unconscious organoids that only loosely resemble the original organs, Live Science has reported. The petri-dish tear glands, however, were pretty close to the real thing, according to Marie Bannier-Hélaouët, a co-lead author of the study and researcher at the Hubrecht Institute in Utrecht, Netherlands.

Related: 11 body parts grown in the lab

Human tear glands, Bannier-Hélaouët told Live Science, have two components: acinar cells and ductal cells.

Those balloons are similar in size to what you’d find in a human, growing up to about one-50th of an inch wide.

3D images: exploring the human brain

Once the cocktail had been perfected, the researchers observed the glands puffing up with tears that had nowhere to go.

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Care During Coma Or Vs

People in a coma or a VS need a lot of care. This care may include:

  • Feeding with a feeding tube.
  • Turning the person while he or she is in bed to prevent pressure injuries .
  • Helping with bowel and bladder relief. This may include using a catheter or diapers.
  • Managing breathing. This may include removing mucus from the airway. It may also include cleaning a tracheostomy tube.
  • Managing muscle tone. This includes helping to relieve extremely tight muscles with positioning and range of motion exercises.
  • Using special equipment. This may include a wheelchair. It could also include special bedding to help with proper posture, decrease muscle tightness, and prevent pressure sores.
  • Treating infections such as pneumonia or urinary tract infections.
  • Managing other health problems such as fevers or seizures.

Transitions To Different Levels Of Care

During recovery, people in the VS or the MCS may get care in many settings. A person with a DOC will likely start treatment in an acute care hospital the focus is on saving the patients life and stabilizing the patient. Once those needs are met, the focus moves to restoring as much function as possible. Sometimes this takes place in an acute rehabilitation hospital. These hospitals provide high-intensity, team-oriented services. Services include physical therapy, occupational therapy, speech-language therapy, recreational therapy, neuropsychological services, and medical and nursing care.

Some patients dont go from the acute care hospital to an acute rehab program. These patients may go directly to a long-term acute care hospital , a skilled nursing facility , a subacute rehab program, or a nursing home. They may also go home with family or have home health care or outpatient treatment. People who get care in an acute rehab program first are usually discharged to one of these places as well.

When patients are medically unstable or dont show signs of recovery for a long time, doctors may consider palliative care. In this type of care, the focus of treatment shifts from recovery to comfort.

Many factors affect where a person with severe DOC or other severe impairments goes after leaving an acute care hospital or rehab program. These factors include:

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Brain Death And Organ Donation

In some cases, a person who is brain dead may be a candidate for organ donation. If the person was a registered organ donor, or if their family knew of their wish to be an organ donor, their death is declared, but the ventilator is left on. Drugs that help preserve the internal organs are still given. The dead person then undergoes an operation to remove viable organs such as kidneys. After the operation is complete, the ventilator is switched off. Funeral arrangements can then be made by the family.

Tests To Confirm Brain Death

Real Men Don

Although rare, a few things can make it appear as though someone is brain dead.

These include drug overdoses and severe hypothermia, where body temperature drops below 32C.

A number of tests are carried out to check for brain death, such as shining a torch into both eyes to see if they react to the light.

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Things To Look For When Considering A Setting To Care For Your Loved One:

Here are some things to look for when choosing a place for care:

  • Your family members current treatment team has received good feedback about the programs quality of care when they have referred others there.
  • The staff make you feel comfortable. They are available to talk about your concerns, and they answer your questions.
  • The program has a multidisciplinary treatment team that, at a minimum, includes a rehabilitation physician, nurse, speech pathologist, physical therapist, occupational therapist, psychologist, and social worker.
  • The treatment team meets together to identify treatment goals and review progress.
  • The program and treatment staff have worked with the same kinds of problems that your family member has.
  • The facility knows about the specific care your loved one needs and can meet those needs. You can help to make sure that a detailed nursing care plan is created.
  • The program includes case management to help plan for the next level of care, whether its moving to a rehabilitation program, an LTACH, a SNF, or home.
  • The program provides education and training for future caregivers.
  • The program has a systematic approach to measure progress in all patients.
  • The program is guided by recommendations for rehab programs from the American Congress of Rehabilitation Medicine and the NIDILRRs Traumatic Brain Injury Model System.
  • The program receives good grades in state and/or federal quality ratings

What Are The Different Types Of Tbi

Brain injury may happen in one of two ways:

  • Closed brain injury. Closed brain injuries happen when there is a nonpenetrating injury to the brain with no break in the skull. A closed brain injury is caused by a rapid forward or backward movement and shaking of the brain inside the bony skull that results in bruising and tearing of brain tissue and blood vessels. Closed brain injuries are usually caused by car accidents, falls, and increasingly, in sports. Shaking a baby can also result in this type of injury .

  • Penetrating brain injury. Penetrating, or open head injuries happen when there is a break in the skull, such as when a bullet pierces the brain.

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What Is The Usual Damage To The Brain After An Aneurysm Bleeds

Once an aneurysm bleeds, the chance of death is about 40% and the chance of some brain damage is about 66 %, even if the aneurysm is treated. If the aneurysm isnt treated quickly enough, another bleed may occur from the already ruptured aneurysm.

Vasospasm is a common complication following a ruptured aneurysm. This can lead to further brain damage. Other problems may include hydrocephalus , difficulty breathing that requires a mechanical ventilator, and infection.

Why is the damage so extensive after bleeding? After blood enters the brain and the space around it, direct damage to the brain tissue and brain function results. The amount of damage is usually related to the amount of blood. Damage is due to the increased pressure and swelling from bleeding directly into the brain tissue, or from local cellular damage to brain tissue from irritation of blood in the space between the brain and the skull.

Blood can also irritate and damage the normal blood vessels and cause vasospasm . This can interrupt normal blood flow to the healthy brain tissue and can cause even more brain damage. This is called an ischemic stroke.

Will treating a ruptured aneurysm reverse or improve brain damage? Once an aneurysm bleeds and brain damage occurs, treating the aneurysm will not reverse the damage. Treatment helps prevent more bleeding.

Causes Of Brain Death

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Brain death can happen when the blood and/or oxygen supply to the brain is stopped.

This can be caused by:

  • cardiac arrest when the heart stops beating and the brain is starved of oxygen
  • a heart attack when the blood supply to the heart is suddenly blocked
  • a stroke when the blood supply to the brain is blocked or interrupted
  • a blood clot a blockage in a blood vessel that disturbs or blocks the flow of blood around your body

Brain death can also be caused by:

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Brain Death Is Legal Death

If someone’s brain dead, the damage is irreversible and, according to UK law, the person has died.

It can be confusing to be told someone has brain death, because their life support machine will keep their heart beating and their chest will still rise and fall with every breath from the ventilator.

But they will not ever regain consciousness or start breathing on their own again. They have already died.

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