Repetitive transcranial magnetic stimulation is a noninvasive treatment technique that can directly alter cortical excitability and improve cerebral functional activity in unconscious patients. To investigate the effe...Repetitive transcranial magnetic stimulation is a noninvasive treatment technique that can directly alter cortical excitability and improve cerebral functional activity in unconscious patients. To investigate the effects and the electrophysiological changes of repetitive transcranial magnetic stimulation cortical treatment, 10 stroke patients with non-severe brainstem lesions and with disturbance of consciousness were treated with repetitive transcranial magnetic stimulation. A quantitative electroencephalography spectral power analysis was also performed. The absolute power in the alpha band was increased immediately after the first repetitive transcranial magnetic stimulation treatment, and the energy was reduced in the delta band. The alpha band relative power values slightly decreased at 1 day post-treatment, then increased and reached a stable level at 2 weeks post-treatment. Glasgow Coma Score and JFK Coma Recovery Scale-Revised score were improved. Relative power value in the alpha band was positively related to Glasgow Coma Score and JFK Coma Recovery Scale-Revised score. These data suggest that repetitive transcranial magnetic stimulation is a noninvasive, safe, and effective treatment technology for improving brain functional activity and promoting awakening in unconscious stroke patients.展开更多
The objective of the present study was to discuss patients with disturbances in consciousness by analyzing nursing records. Observations from clinical nurses as well as patients’ responses about their care were selec...The objective of the present study was to discuss patients with disturbances in consciousness by analyzing nursing records. Observations from clinical nurses as well as patients’ responses about their care were selected from nursing records. Nursing records from one week of patient care were examined for patients who were unable to speak during hospitalization within a neuro-surgery ward of the hospital. Selected records were classified into the following eight categories: results from monitoring;results from observation;opening and moving the eyes to stimulus;movement of the limbs to stimulus;vocalization to stimulus;facial expression to stimulus;patient’s response to care;and miscellaneous. Patients comprised two groups. One group encompassed eight patients with Japan Coma Scale (JCS) II and the other was a group of eight patients with JCS III. When nurses use the JCS to assess patients with disturbances in consciousness, patients who awaken to stimulus are classified as JCS II, while those who do not are JCS III. The total nursing records selected for JCS II were 1551 and 1160 for JCS III. The category of “results from monitoring” was the most selected category within nursing records and accounted for 42.8% of the JCS III group, while “results from observation” accounted for 38.4% of the JCS II group. Furthermore, results indicated that the categories of “results from monitoring”, “results from observation”, and “movement of the limbs for stimulus” had peaked after two to three days, and then abruptly decreased. There were only a few records for the categories of “vocalization to stimulus” and “facial expression to stimulus”, both for the JCS II and the JCS III groups. Even though patients could not verbally indicate their intentions due to problems with consciousness, it is essential for nurses to pay careful attention to the details of patients’ reactions.展开更多
The paper presents a description of the experience of the nursing for the Pseudomonas aeruginosa pneumonia patient with partial laryngectomy. The nursing of Pseudomonas aeruginosa pneumonia, conscious disturbance, ele...The paper presents a description of the experience of the nursing for the Pseudomonas aeruginosa pneumonia patient with partial laryngectomy. The nursing of Pseudomonas aeruginosa pneumonia, conscious disturbance, electrolyte disorder, affection supports and mental nursing was provided in the process of the postoperative treatment. Our experience may provide useful insight for the nursing of laryngectomy patients secondary to pneumonia with conscious disturbance. A deeper knowledge about improving the quality of clinic special nursing for the partial or total laryngectomy patient is necessary, with the development of modern medical technologies and medicine.展开更多
Objective: The objective of this study was to clarify the characteristics of nurses’ eye movements during observation of patients with disturbed consciousness by comparing intuition ability, critical thinking, and cl...Objective: The objective of this study was to clarify the characteristics of nurses’ eye movements during observation of patients with disturbed consciousness by comparing intuition ability, critical thinking, and clinical experience years. Methods: Participants were 19 nurses working on a neurosurgery ward in Japan and caring for patients with consciousness disturbance who were unable to speak. Ten novice nurses (24.8 ± 3.36 years old) and nine expert nurses (38.3 ± 5.77 years old) were compared. The observation scene, displayed on a computer screen, was a static image of a simulated patient in a resting state who had developed right putaminal hemorrhage. We showed the participants an information sheet about the simulated patient then used an eye tracking camera to analyze gaze points, gaze time, and gaze count during observation. The Kuroda Intrinsic Intuitive Ability Scale (KIIS) created by Kawahara and the Critical Thinking Disposition Scale created by Hirayama were used for measuring intrinsic intuition ability and critical thinking disposition. Results: There were no significant differences between observation time of novices (5.0 ± 2.01 minutes) and experts (5.4 ± 1.78 minutes), nor between their total gaze time and total count. The proportion of gazing at the monitor by novice nurses and gazing at the face and bed fences by expert nurses tended to be high. The KIIS general education score influenced the gaze time and gaze count during simulated patient observation. The KIIS logical thinking score affected the gaze count to the simulated patient’s face. Conclusion: There was no significant difference between the total gaze time and the total count of novices and experts. The KIIS score affected the gaze during observation of the simulated patient.展开更多
BACKGROUND Disorders of consciousness including coma in non-trauma patients can be caused by a wide variety of pathologies affecting the central nervous system.They represent a frequent challenge in emergency medicine...BACKGROUND Disorders of consciousness including coma in non-trauma patients can be caused by a wide variety of pathologies affecting the central nervous system.They represent a frequent challenge in emergency medicine and are combined with a very high in-hospital mortality.Hence,early treatment of these patients is vital and increases the likelihood of a good outcome.AIM To identify the causes of altered consciousness presentation to the Emergency Department at Suez Canal University Hospital.METHODS This was a descriptive cross-sectional study conducted on 87 patients with acute non-traumatic disturbed level of consciousness(DLOC)at the Emergency Department.RESULTS The mean age of the studied patients was 60.5±13.6 years.Among them,60%were males and 40%were females.The most common cause of acute non-traumatic DLOC was systemic infection,such as sepsis and septic shock(25.3%),followed by respiratory causes(24.1%)and neurological causes(18.4%).CONCLUSION The most common cause of acute non-traumatic DLOC was systemic infections followed by respiratory and neurological causes.展开更多
Cerebral disorders are often associated with disturbance of consciousness. Since the latter could alter the prognosis of physical function, early improvement of consciousness level is important. The present study test...Cerebral disorders are often associated with disturbance of consciousness. Since the latter could alter the prognosis of physical function, early improvement of consciousness level is important. The present study tested the hypothesis that sitting position improves disturbances of consciousness in patients with cerebral disorders. The subjects were 17 patients with cerebral disorders and disturbances of consciousness. The consciousness level was evaluated in supine position and following a change to sitting position. The consciousness level was evaluated by the Glasgow Coma Scale (GCS). The total, eye opening, and motor GCS scores were significantly higher in the sitting position compared with the supine position. In conclusions, changing from supine to sitting position improves consciousness level in patients with cerebral disorders.展开更多
基金founded by Committee of Science and Technology, Fengtai District of Beijing City in 2010,No.xm101223
文摘Repetitive transcranial magnetic stimulation is a noninvasive treatment technique that can directly alter cortical excitability and improve cerebral functional activity in unconscious patients. To investigate the effects and the electrophysiological changes of repetitive transcranial magnetic stimulation cortical treatment, 10 stroke patients with non-severe brainstem lesions and with disturbance of consciousness were treated with repetitive transcranial magnetic stimulation. A quantitative electroencephalography spectral power analysis was also performed. The absolute power in the alpha band was increased immediately after the first repetitive transcranial magnetic stimulation treatment, and the energy was reduced in the delta band. The alpha band relative power values slightly decreased at 1 day post-treatment, then increased and reached a stable level at 2 weeks post-treatment. Glasgow Coma Score and JFK Coma Recovery Scale-Revised score were improved. Relative power value in the alpha band was positively related to Glasgow Coma Score and JFK Coma Recovery Scale-Revised score. These data suggest that repetitive transcranial magnetic stimulation is a noninvasive, safe, and effective treatment technology for improving brain functional activity and promoting awakening in unconscious stroke patients.
文摘The objective of the present study was to discuss patients with disturbances in consciousness by analyzing nursing records. Observations from clinical nurses as well as patients’ responses about their care were selected from nursing records. Nursing records from one week of patient care were examined for patients who were unable to speak during hospitalization within a neuro-surgery ward of the hospital. Selected records were classified into the following eight categories: results from monitoring;results from observation;opening and moving the eyes to stimulus;movement of the limbs to stimulus;vocalization to stimulus;facial expression to stimulus;patient’s response to care;and miscellaneous. Patients comprised two groups. One group encompassed eight patients with Japan Coma Scale (JCS) II and the other was a group of eight patients with JCS III. When nurses use the JCS to assess patients with disturbances in consciousness, patients who awaken to stimulus are classified as JCS II, while those who do not are JCS III. The total nursing records selected for JCS II were 1551 and 1160 for JCS III. The category of “results from monitoring” was the most selected category within nursing records and accounted for 42.8% of the JCS III group, while “results from observation” accounted for 38.4% of the JCS II group. Furthermore, results indicated that the categories of “results from monitoring”, “results from observation”, and “movement of the limbs for stimulus” had peaked after two to three days, and then abruptly decreased. There were only a few records for the categories of “vocalization to stimulus” and “facial expression to stimulus”, both for the JCS II and the JCS III groups. Even though patients could not verbally indicate their intentions due to problems with consciousness, it is essential for nurses to pay careful attention to the details of patients’ reactions.
文摘The paper presents a description of the experience of the nursing for the Pseudomonas aeruginosa pneumonia patient with partial laryngectomy. The nursing of Pseudomonas aeruginosa pneumonia, conscious disturbance, electrolyte disorder, affection supports and mental nursing was provided in the process of the postoperative treatment. Our experience may provide useful insight for the nursing of laryngectomy patients secondary to pneumonia with conscious disturbance. A deeper knowledge about improving the quality of clinic special nursing for the partial or total laryngectomy patient is necessary, with the development of modern medical technologies and medicine.
文摘Objective: The objective of this study was to clarify the characteristics of nurses’ eye movements during observation of patients with disturbed consciousness by comparing intuition ability, critical thinking, and clinical experience years. Methods: Participants were 19 nurses working on a neurosurgery ward in Japan and caring for patients with consciousness disturbance who were unable to speak. Ten novice nurses (24.8 ± 3.36 years old) and nine expert nurses (38.3 ± 5.77 years old) were compared. The observation scene, displayed on a computer screen, was a static image of a simulated patient in a resting state who had developed right putaminal hemorrhage. We showed the participants an information sheet about the simulated patient then used an eye tracking camera to analyze gaze points, gaze time, and gaze count during observation. The Kuroda Intrinsic Intuitive Ability Scale (KIIS) created by Kawahara and the Critical Thinking Disposition Scale created by Hirayama were used for measuring intrinsic intuition ability and critical thinking disposition. Results: There were no significant differences between observation time of novices (5.0 ± 2.01 minutes) and experts (5.4 ± 1.78 minutes), nor between their total gaze time and total count. The proportion of gazing at the monitor by novice nurses and gazing at the face and bed fences by expert nurses tended to be high. The KIIS general education score influenced the gaze time and gaze count during simulated patient observation. The KIIS logical thinking score affected the gaze count to the simulated patient’s face. Conclusion: There was no significant difference between the total gaze time and the total count of novices and experts. The KIIS score affected the gaze during observation of the simulated patient.
文摘BACKGROUND Disorders of consciousness including coma in non-trauma patients can be caused by a wide variety of pathologies affecting the central nervous system.They represent a frequent challenge in emergency medicine and are combined with a very high in-hospital mortality.Hence,early treatment of these patients is vital and increases the likelihood of a good outcome.AIM To identify the causes of altered consciousness presentation to the Emergency Department at Suez Canal University Hospital.METHODS This was a descriptive cross-sectional study conducted on 87 patients with acute non-traumatic disturbed level of consciousness(DLOC)at the Emergency Department.RESULTS The mean age of the studied patients was 60.5±13.6 years.Among them,60%were males and 40%were females.The most common cause of acute non-traumatic DLOC was systemic infection,such as sepsis and septic shock(25.3%),followed by respiratory causes(24.1%)and neurological causes(18.4%).CONCLUSION The most common cause of acute non-traumatic DLOC was systemic infections followed by respiratory and neurological causes.
文摘Cerebral disorders are often associated with disturbance of consciousness. Since the latter could alter the prognosis of physical function, early improvement of consciousness level is important. The present study tested the hypothesis that sitting position improves disturbances of consciousness in patients with cerebral disorders. The subjects were 17 patients with cerebral disorders and disturbances of consciousness. The consciousness level was evaluated in supine position and following a change to sitting position. The consciousness level was evaluated by the Glasgow Coma Scale (GCS). The total, eye opening, and motor GCS scores were significantly higher in the sitting position compared with the supine position. In conclusions, changing from supine to sitting position improves consciousness level in patients with cerebral disorders.
