Aim: To support ward staff in caring for the brain injured patient during the post acute phase of their recovery. To provide initial pointers for assessment and management to be supplemented by seeking expert advice when possible.
The early stages of recovery following brain injury present many complex challenges which require careful assessment and management. The information below is not focused on the acute intensive care or the surgical interventions required to stabilise the patient following brain injury, but rather on those medical issues which occur in the stabilised patient during the initial days and weeks of recovery following brain injury.
Challenges which may arise in this phase include:
- Assessment and Management of Physical or Psychological Distress
- Paroxysmal Sympathetic Hyperactivity/Dysautonomia
- Pain Symptoms
- Spasticity
- Assessment and management of confusion:
- Assessment and Management of Anxiety and Agitation
- Capacity Issues and Legislation
- Maintaining metabolic (Sodium Balance or Pituitary Problems) and Nutritional homeostasis.
- Dilemmas relating to seizure prevention
- Immobility and associated complications
- Pressure care
- Bladder and Bowel Dysfunction
- Risk of Venous Thromboembolism and risks of anticoagulation.
- Assessment of consciousness
- Management of patients with Pre-existing Alcohol or Substance Misuse
- Giving a Prognosis in the Early Stages of Recovery following Brain Injury: What to say and what not to say.
