The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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By focusing our attention on the questions of "what are we trying to achieve" and "are we able to do it", the discussion of medical futility has contributed an important dimension to the ethics of treatment decision making near the end of life. It is not simply enough to ask and answer the question of what the patient wants. Healthcare professionals have a responsibility to offer only those life-sustaining efforts that have a reasonable chance of being beneficial. ⋯ The recognition of the significance of the concept of futility means that discussion needs to continue at another level as well. The questions of "what are we trying to achieve" and "are we able to do it" are not easily answered. It is especially important, we think, that those who are experienced in working with patients with neurological impairments contribute to the on-going reflection on what constitutes benefit or what is the appropriate use of life-sustaining interventions for such patients.
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Computerized EEG (CEEG) monitoring has recently been introduced to intensive care units (ICU). Unlike the intermittent assessment using coma scales, CEEG monitoring provides continuous information about a patients' neurological condition. Patient status can be monitored more accurately with CEEG. ⋯ The goal of continuous CEEG monitoring is to recognize a decline in a patient's condition before physical signs and symptoms are present. The neuroscience nurse participates in the assessment of the EEG recording as well as in evaluating therapy. This article introduces the neuroscience nurse to the basic terminology, rationale for use and clinical application for continuous computerized EEG monitoring.
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The purpose of this study was to test the interrater reliability of the Glasgow Coma Scale (GCS) when used in assessing neurologically impaired patients. In order to control variables, a videotape was developed of seven patients with different neurological impairments. ⋯ The comparison showed a low disagreement rating and a moderate to high agreement rating demonstrating that this tool has good interrater reliability (p = 0.000). Nurses may use this tool with confidence as one measure of assessment in evaluating neurologically impaired patients.
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An acute spinal cord injury has been described as one of the most devastating traumatic types of neurological impairment. Twelve years ago I had the misfortune of experiencing this first hand. From the day of my brother's initial injury I began keeping a diary of what this experience was like. The concept of entitlement and indebtedness has been applied to my family's experience.