Pupillary Reflex Perimeter for Children and Unconscious Patients

2015 ◽  
pp. 199-199
Author(s):  
K. Sugita ◽  
Y. Sugita ◽  
N. Mutsuga ◽  
Y. Takaoka
Keyword(s):  
Pupillary Reflex ◽  
Unconscious Patients

scholarly journals Evaluation of Nociception Using Quantitative Pupillometry and Skin Conductance in Critically Ill Unconscious Patients: A Pilot Study

2021 ◽  
Vol 11 (1) ◽  
pp. 109
Author(s):  
Sara Fratino ◽  
Lorenzo Peluso ◽  
Marta Talamonti ◽  
Marco Menozzi ◽  
Lucas Akira Costa Hirai ◽  
...  
Keyword(s):  
Brain Injury ◽  
Critically Ill ◽  
Skin Conductance ◽  
Pain Control ◽  
Deep Level ◽  
Pupillary Response ◽  
Tetanic Stimulation ◽  
Pupillary Reflex ◽  
Background Pain ◽  
Unconscious Patients

Background: Pain assessment is a challenge in critically ill patients, in particular those who are unable to express movements in reaction to noxious stimuli. The purpose of the study was to compare the pupillary response and skin conductance to pain stimulation in critically ill unconscious patients. Methods: This observational study included adult patients admitted to the intensive care unit (ICU) with acute brain injury (Glasgow Coma Scale < 9 with a motor response < 5) and/or requirements for deep level of sedation. Automated pupillometry (Algiscan, ID-MED, Marseille, France) was used to determine pupillary reflex dilation during tetanic stimulation. The maximum intensity of the stimulation value allowed the determination of a pupillary pain index score ranging from 1 (no nociception) to 9 (high nociception): a pupillary pain index (PPI) score of ≤4 was used to reflect adequate pain control. For skin conductance (SC), the number of SC peaks per second (NSCF) was collected concomitantly to tetanic stimulation. An NSCF of ≤0.07 peak/second was used to reflect adequate pain control. Results: Of the 51 included patients, there were 32 with brain injury and 19 receiving deep sedation. Mean PPI score was 5 (Interquartile Range= 2–7); a total of 28 (55%) patients showed inadequate control of the nociceptive stimulation according to the PPI assessment. Only 15 (29%) patients showed a detectable skin conductance, with NSCF values from 0.07 to 0.47/s. No correlation was found between skin conductance algesimeter (SCA)-derived variables and PPI score or pupillary dilation to pain. Conclusions: Detection of inadequate pain control might vary according to the method used to assess nociception in ICU patients. A poor agreement between quantitative pupillometry and skin conductance was observed.

scholarly journals Observations on the Ethical and Social Aspects of Disorders of Consciousness

2010 ◽  
Vol 37 (6) ◽  
pp. 758-768 ◽  
Author(s):  
Eric Racine ◽  
Catherine Rodrigue ◽  
James L. Bernat ◽  
Richard Riopelle ◽  
Sam D. Shemie
Keyword(s):  
Life Support ◽  
Functional Neuroimaging ◽  
Vegetative State ◽  
Clinical Care ◽  
Disorders Of Consciousness ◽  
Artificial Nutrition ◽  
Artificial Nutrition And Hydration ◽  
Neuroscience Research ◽  
Nutrition And Hydration ◽  
Unconscious Patients

AbstractThe care of chronically unconscious patients raises vexing medical, ethical, and social questions concerning diagnosis, prognosis, communication with family members, and decision making, including the withdrawal of life support. We provide updates on major controversies surrounding disorders of consciousness. Issues such as withdrawal of artificial nutrition and hydration – which had been considered “settled” by many in the medical, legal and ethical communities – have resurfaced under the pressure of social groups and religious authorities. Some assumptions about the level of awareness and the prognosis of vegetative state and minimal conscious patients are questioned by advances in clinical care because of insights produced by neuroscience research techniques, particularly functional neuroimaging. Both the clinical and neuroscience dimensions of disorders of consciousness raise complex issues such as resource allocation and high levels of diagnostic inaccuracies (at least, for the vegetative state). We conclude by highlighting areas needing further research and collaboration.

scholarly journals Laporan Kasus: Penanganan Korneal Squestrum pada Kucing Domestic Short Hair

2020 ◽  
Vol 31 (3) ◽  
pp. 137
Author(s):  
Ganang Rilo Pambudi
Keyword(s):  
Short Hair ◽  
Pupillary Reflex

Korneal squestrum merupakan suatu keadaan yang terjadi pada kornea yang telah mengalami kornea ulser dalam kurun waktu yang panjang/kronis. Kornea merupakan struktur pada mata bagian depan yang memiliki warna transparan dan tersusun atas outer epitelium, middle stroma dan inner endothelium. Pemeriksaan dasar yang dilakukan pada pasien adalah menace, dazzle dan pupillary reflex. Sedangkan pemeriksaan penunjang yang dilakukan adalah schiemer tear test dan fluorescein test. Hasil pemeriksaan dasar menunjukkan hasil yang positif tanpa adanya gangguan penglihatan. Sedangkan hasil fluorescein test menunjukkan hasil positif kornea ulser dengan adanya pendaran warna hijau. Terapi dilakukan dengan memberikan antibiotik (cendo genta 0,3%) s.6.d.d selama 2 minggu. Respon possitif ditunjukkan oleh pasien dengan hasil fluorescein test negatif pasca 2 minggu pengobatan. Akan tetapi, masih terdapat jaringan-jaringan berwarna putih kecoklatan yang menutupi permukaan korneal. Terapi dilanjutkan dengan memberikan cendoxitrol s.2.d.d selama 2 minggu. Respon yang diberikan pasien kurang baik, jaringan berubah menjadi kecoklatan atau disebut dengan korneal squestrum. 

scholarly journals Pengetahuan, Sikap dan Keterampilan Perawat tentang Oral Care pada Pasien Tidak Sadar

2020 ◽  
Vol 11 (2) ◽  
pp. 133
Author(s):  
Endah Fitriasari ◽  
Elly L. Sjattar ◽  
Kusrini S. Kadar
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Oral Care ◽  
Oral Health Care ◽  
Google Scholar ◽  
Cross Sectional ◽  
Care Services ◽  
Randomized Intervention ◽  
Intervention Trials ◽  
Unconscious Patients

Background: Providing oral care for adults who are hospitalized with dependency is a nursing responsibility and is an important component of providing nursing care services, as an effort to maintain general health. Objective: To observe nurses' knowledge, attitudes and skills about oral care in unconscious patients. Methods: Using an database to search for articles from journals that had been published through PubMed, Google Scholar, and Proquest. Results: Six articles that discussed oral health care knowledge, attitudes and skills were included in the review. There were three articles with cross-sectional designs and one article each for descriptive, non-randomized intervention trials and mixed methods. Conclusion: Efforts to renew knowledge, attitudes and improve oral health care skills can be done through training or through oral health programs. Keywords: knowledge; attitudes; nurse skills; oral care; unconscious patients ABSTRAK Latar Belakang: Memberikan oral care untuk orang dewasa yang dirawat di rumah sakit dengan ketergantungan adalah tanggung jawab keperawatan dan merupakan komponen penting dari pemberiaan layanan asuhan keperawatan, sebagai upaya menjaga kesehatan secara umum. Tujuan: Untuk melihat pengetahuan, sikap dan keterampilan perawat tentang oral care pada pasien tidak sadar. Metode: Menggunakan basis data elektronik dalam mencari artikel dari jurnal yang telah dipublikasikan melalui PubMed, Google scholar, dan Proquest. Hasil: Enam artikel yang membahas tentang pengetahuan, sikap dan keterampilan perawatan kesehatan mulut dimasukkan dalam tinjauan. Terdapat tiga artikel dengan desain cross- sectional serta masing- masing satu artikel untuk deskriptif, non-randomized intervention trial dan mixed method. Kesimpulan: Upaya memperbaharui pengetahuan, sikap dan meningkatkan keterampilan perawatan kesehatan mulut dapat dilakukan dengan pelatihan ataupun melalui program kesehatan mulut. Kata kunci: pengetahuan; sikap; keterampilan perawat; oral care; pasien tidak sadar

scholarly journals Clinical approach to coma patients: tips and tricks

2021 ◽  
Keyword(s):  
Clinical Evidence ◽  
Primary Treatment ◽  
Clinical Approach ◽  
Loss Of Consciousness ◽  
Tips And Tricks ◽  
Secondary Complications ◽  
Reticular Activating System ◽  
Four Levels ◽  
Unconscious Patients ◽  
Normal Status

The reticular activating system (RAS) is responsible for wakefulness. The RAS projects activation to either side of the hemisphere. The dysfunction of the RAS or insufficiency of its activation results in impairment of consciousness. Physicians classify levels of awareness into four levels, from normal status to most severe unconsciousness, these being alert, drowsy, stupor, and coma, respectively. While the causes of unconsciousness are varied, physicians generally divide them into structural and metabolic etiologies upon the dominant approach. Surgical management is the primary treatment for the structural coma, while the metabolic coma requires predominantly medical treatment. The diagnosis and management of unconscious patients require extensive clinical assessment, consisting of a careful approach to history-taking and general medical and neurological examinations. Following immediate resuscitation by the ABCDE approach and proper management protocols, physicians should look for causes of loss of consciousness through clinical evidence and investigations. Appropriate management will help to avoid secondary complications related to the impairment of consciousness. The prognostication of a coma is also varied and primarily depends on its etiology. The algorithm for prognostication in a coma is helpful for poor outcome determinants.

scholarly journals Pupillary reflex measurement predicts insufficient analgesia before endotracheal suctioning in critically ill patients

Critical Care ◽  
2013 ◽  
Vol 17 (4) ◽  
pp. R161 ◽  
Author(s):  
Jerome Paulus ◽  
Antoine Roquilly ◽  
Hélène Beloeil ◽  
Julien Théraud ◽  
Karim Asehnoune ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Endotracheal Suctioning ◽  
Pupillary Reflex

scholarly journals Occurrence of Staphylococcal Ocular Infections of Food Producing Animals in Nsukka Southeast, Nigeria

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sunday Ositadinma Udegbunam ◽  
Rita Ijeoma Udegbunam ◽  
Madubuike Umunna Anyanwu
Keyword(s):  
Animal Species ◽  
Blink Reflex ◽  
Diffusion Method ◽  
Drug Resistant ◽  
Disc Diffusion Method ◽  
Isolation And Identification ◽  
Pupillary Reflex ◽  
Antibiotic Resistant ◽  
Ocular Infections ◽  
Eye Lesions

Staphylococcal ocular infections of food animals have been somewhat under diagnosed probably due to the ubiquitous nature of staphylococcal organisms. This study was undertaken to determine the occurrence of staphylococcal ocular infections of food producing animals in Nsukka Southeast, Nigeria, and to determine the antibiogram of the isolated staphylococci. A total of 5,635 food producing animals were externally examined for signs of clinical ocular conditions. Animals that showed clinical eye lesions were further examined using pen light to assess the entire globe and the pupillary reflex. Blindness was assessed using menace blink reflex, palpebral reflex and obstacle methods. Isolation and identification of staphylococcal isolates from ocular swabs were done by standard methods. Antibiogram of the isolates was determined by disc diffusion method. Sixty-three (1.1%) of the examined animals showed signs of ocular condition. Thirty-one (49.2%) of the cultured swabs yieldedStaphylococcus aureus(S. aureus). Isolation rates from different animal species were caprine (60%), ovine (33.3%), bovine (12.5%), and porcine (0%). Resistance of the isolates was 100% to ampicillin/cloxacillin, 90% to tetracycline, 80% to streptomycin, 71% to chloramphenicol, 20% to erythromycin, 16% to gentamicin, and 0% to ciprofloxacin and norfloxacin. Twenty-five (81%) of the isolates were multi-drug resistant. This study has shown that antibiotic-resistant staphylococci are associated with a sizeable percentage of ocular infections of food producing animals and should be considered during diagnosis and treatment.

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