Severe brain injury rehabilitation. What's going to happen after critical care.
Treatment advances and technology will continue to decrease mortality in SBI in the future. A clearer line between lingering death and reasonable potential for recovery will only slowly reveal itself, and prediction will never be an exact science. Concerns about resource utilization and costs will continue to escalate. Critical care, acute care, and rehabilitation nurses will continue to live in this painful haze with the patients and their families. Nevertheless, critical care nurses can help by assisting families to understand the possible outcomes of SBI, the clinical state the patient is experiencing, how diagnosis and prognosis are related and how they are different, the indicators used to establish prognosis early on and then later in the course, and how prognosis is related to treatment decisions. Likewise, the critical care nurses can help the family begin to come to terms with the level of sophistication (or lack of precision, as the case may be) of prognostication, the agonizing time length factor involved, and the demanding prerequisites for level of consciousness assessment in the low functioning clinical states.
Boss
B J
BJ
School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA. bboss@son.umsmed.edu
Fletcher
A
A
D001930:Brain Injuries / Q000534:rehabilitation*; D003422:Critical Care; D006304:Health Status; D006801:Humans; D008279:Magnetic Resonance Imaging; D017063:Outcome Assessment, Health Care; D011379:Prognosis