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The diagram below depicts brain injury treatment in an orderly progression from trauma care to community integration. After receiving emergency medical treatment, persons with a moderate to severe brain injury may be admitted to a hospital’s Inpatient Intensive Care Unit. Intubation with the use of a ventilator allows a person to breathe and receive oxygen, which is necessary for life.
A Nasogastric Tube (NG Tube) is used to deliver medication and nutrients directly to a person’s stomach.
A tube is placed through a person’s nose or mouth and ran through the swallowing passage (the esophagus), to the stomach.
An Intracranial Pressure (ICP) Monitor is a device attached to a person’s head with a monitor that indicates the amount of pressure in the brain. If the brain swells and has no place to expand, this can cause brain tissues to compress, causing further injury.
A Pulse Oximeter is a small, clamp-like device placed on a person’s finger, toe or earlobe. As early as possible in the recovery process, individuals who sustain brain injuries will begin acute rehabilitation.
When patients are well enough to participate in more intensive therapy, they may be transferred to a postacute rehabilitation setting, such as a residential rehabilitation facility. Patients who cannot tolerate intensive therapy may be transferred to a subacute rehabilitation facility. Day treatment provides rehabilitation in a structured group setting during the day and allows the person with a brain injury to return home at night. Community re-entry programs generally focus on developing higher level motor, social, and cognitive skills in order to prepare the person with a brain injury to return to independent living and potentially to work. Independent living programs provide housing for persons with brain injury with the goal of regaining the ability to live as independently as possible.
Medications for persons with brain injury are carefully selected, prescribed, and monitored by the physician on an individual basis. Anti-Psychotics may be used to target psychotic symptoms of combativeness, hostility, hallucinations, and sleep disorders.
Sedative-Hypnotic Agents may be used to induce sleep or depress the central nervous system in areas of mental and physical response, awareness, sleep, and pain. Alternative medicines, including alternative therapies, are an under-researched area of brain injury treatment. Occupational Therapists use purposeful activities as a means of preventing, reducing, or overcoming physical and emotional challenges to ensure the highest level of independent functioning in meaningful daily living.
Recreational Therapists provide activities to improve and enhance self-esteem, social skills, motor skills, coordination, endurance, cognitive skills, and leisure skills. Aquatic Therapists are occupational therapists, physical therapists, or recreational therapists with specialized training to provide therapy in a heated water pool.
Several scales and measures are used to rate and record the progress a person makes in rehabilitation following a brain injury. The Functional Independent Measure (FIM) is a scale that rates an individual’s independence level with activities of daily living.
The Functional Assessment Measure (FAM) is used in conjunction with the Functional Independent Measure (FIM). This is NOT the same as the Glasgow Coma Scale The Glasgow Outcome Scale is a very broad scale and has been shown to have very little functional value for people in rehabilitation. Level I - No ResponsePatient appears to be in a deep sleep and is completely unresponsive to any stimuli presented to him.
Patient is in a heightened state of activity with severely decreased ability to process information. Patient appears alert and is able to respond to simple commands fairly consistently; however, with increased complexity of commands or lack of any external structure, responses are non-purposeful, random, or, at best, fragmented toward any desired goal.
Patient appears appropriate and oriented within hospital and home settings, goes through daily routine automatically, but frequently robot-like, with minimal-to-absent confusion, but has shallow recall of what he has been doing. Patient is alert and oriented, is able to recall and integrate past and recent events, and is aware of, and responsive to, his culture.
BIAA has chartered affiliates that provide provide information and resource services, linkage to support groups, awareness and prevention programs, education, advocacy and more. Support groups can help individuals with brain injury increase their knowledge about brain injury and cope with the issues they face.
Constipation refers to the condition where bowel movements are irregular and the process of passing stools can be painful. Our perceptions of constipation can also vary as this depends on what one views as regular bowel movements.
For chronic cases, where the problem of constipation frequently recurs or is long lasting, a more aggressive form of treatment may be necessary.
If the problem of constipation is acute or chronic, it is best to consult with your doctor to determine the underlying cause. Mild cases of constipation can be treated with over-the-counter stool softeners and laxatives. Some laxatives may interact with certain medications so always check with your doctor if you are already on medications for any other health condition.
You can also provide constipation relief with a number of simple natural cures or home remedies. Herbs such as flaxseed, fenugreek or barley work as bulk forming laxatives and are excellent chronic constipation cures.
Pears and pear juice if consumed at breakfast and dinner time can help relieve constipation symptoms. Guava eaten raw with the seeds provides enough roughage to relieve constipation and soften stools naturally. Dried or fresh figs, prunes and prune juice and fresh papaya are other fruits that are used to treat constipation. You could also drink a glass of hot water with half a teaspoon of salt and the juice of half a lime added to it. An ideal diet to cure constipation and prevent its recurrence is one that is high in fresh fruits and vegetable, especially those with high fiber content. If you are pregnant and suffer from constipation stay away from laxatives and over-the-counter medications as these can cause premature contractions. Health advice on Constipation: My daughter is 9 weeks old and is having trouble with constipation. Health advice on dates: how can dates help to relieve constipation and intestinal disturbances?
Treatment for scars and constipation: im 22yrs old and i had severe acne but after using medicine I'm better now but there are scars on my cheeks as well. Remedy for cramps in stomach: I have been having cramps in the central part of my stomach for a few days, I thought it was constipation but I am still not sure, I have taken stool softeners but with no real results. Treatment for constipation and gastritis in quadriplegia: How can you treat constipation and gastritis in a quadriplegic person without use of harsh medications? Consume Two Tea Spoon full of VIRGIN COCONUT OIL before going to bed; this will also be a natural and organic remedy for reducing weight as well.
Please be warned strictly no dates my diabetic doctor professor kah yin from diabetics clinic. Streptococcal sore throat or famously known as strep throat is a respiratory condition that is caused by a specific streptococcal bacteria. As the infection progresses, the tendency is that more symptoms come about such as runny nose, cough, hoarseness, eye redness, muscle aches, ulcers in the mouth, and diarrhea which may suggest viral infection. Seeking for medical help is indeed a must especially when one experiences fever as this can indicate progression of the infection. Strep throat can be very contagious and can easily spread from one person to another easily. In order to avoid such infection, one should be doing the necessary measures to avoid the spread of illness.
Their choices, goals and cultural, religious, social and economic backgrounds must always be taken into consideration in treatment planning. The goals in the ICU include achieving medical stability, medical management, and prevention of medical crisis. Many tubes, wires, and pieces of medical equipment may be attached to the patient to provide life sustaining medical care. This allows urine to move from the bladder, through the tube, and to a container at the end of the tube. The treatment is provided in a special unit of the trauma hospital, a rehabilitation hospital or another inpatient setting. The goal of postacute rehabilitation is to help the patient regain the most independent level of functioning possible. Subacute rehabilitation programs are designed for persons with brain injury who need a less intensive level of rehabilitation services over a longer period of time.


Treatment may focus on safety in the community, interacting with others, initiation and goal setting and money management skills. The physician or pharmacist can explain a medication’s purpose, side effects and precautions to you. The National Center for Complementary and Alternative Medicine (part of the National Institutes of Health) offers a Guide to Complementary and Alternative Medicines. The Brain Injury Association also published an issue of the Challenge! The physiatrist typically serves as the leader for the rehabilitation treatment team and makes referrals to the various therapies and medical specialists as needed. The physical therapist focuses on improving physical function by addressing muscle strength, flexibility, endurance, balance, and coordination. A rehabilitation nurse attempts to maintain the person’s medical status, anticipate potential complications, and work on goals to restore a person's functioning. Maintains regular contact with the patient's insurance carrier, family, and referring physician to assure that treatment goals are understood and achieved. Recreational therapists plan community outings to allow the person to directly apply learned skills in the community. Neuropsychologists provide services to reduce the impact of setbacks and to help the person return to a full productive life. Aquatic therapists assist a person to increase strength, coordination, ambulation skills, endurance, muscle movement, and reduce pain.
This scale considers cognitive and physical function, impairment, disability and handicap to present a global depiction of the individual’s disability. Areas of activities of daily living include self-care, bowel and bladder management, locomotion, transfers, communication, and social cognition.
The FAM was developed specifically for people with brain injury and consists of 12 items added to the 18 items of the Functional Independence Measure (FIM).
Responses are directly related to the type of stimulus presented as in turning head toward a sound or focusing on an object presented. He may show agitated behavior, but not on an internal basis (as in Level IV), but rather as a result of external stimuli, and usually out of proportion to the stimulus. Response to discomfort is appropriate and he is able to tolerate unpleasant stimuli (as NG tube) when need is explained. He shows increased awareness of self, body, family, foods, people, and interaction in the environment. He shows carry-over for new learning if acceptable to him and his life role, and needs no supervision once activities are learned. Support group members can provide valuable emotional support because of their experiences and understanding of the impact of brain injury. People are overcome by feelings of severe despair over an extended period of time.The tunnel, however, is not entirely dark anymore.
Most people suffer from constipation at some point of time but some may complain of more frequent bouts than others.
While some individuals need to pass a stool at least twice or thrice a day, for some others regular bowel movements may simply include passing a stool once in two or three days. While this could occur in any part of the intestine in almost all cases this occurs in the colon.
You may need to undergo a series of blood tests, stool tests and abdominal x-rays to rule out various factors that may be causing the constipation. However, these drugs should not be used for long periods of time or to treat chronic cases of constipation. For milder cases of constipation bulk forming laxatives that contain fiber are recommended. They contain soluble fiber that helps soften stools and reduces discomfort during bowel movements. Dilute aloe vera juice in water and drink first thing in the morning and last thing at night for regular bowel movements. If the constipation is severe, a fruit only diet for a few days will go a long ways towards clearing up the condition. Grape juice can help tone the internal muscles of the stomach and prevent chronic constipation.
Oranges also help prevent the accumulation of waste matter in the colon and reduces the chances of constipation. Dried fruits, whole grains, cereals, and vegetables are the best ways to get fiber into your diet. Laxative effects of partially defatted flaxseed meal on normal and experimental constipated mice. Comparative laxation of psyllium with and without senna in an ambulatory constipated population.
I gave her her gerber and she has not been able to go for 3-4 days now, what can i give her that is as natural as possible?
What you will need, - A Mug - Water - Honey - Lemon or Lime - Spoon - Yourself -My remedy consists of, wake up earlier then usual. This condition is most common to the young especially the school-aged children and teenagers. But because of the possibility of no presenting symptoms, the spreading of the infection can be fast with no known source as this can be masked by some. This self-care management is very easy to do and can assist in the medical management which the doctor has recommended. Direct contact from the infected person makes one susceptible in the development of strep throat. But as one acquires the bacterial infection, the symptoms generally start to present themselves 1 to 4 days after exposure. Individuals who sustain brain injuries may enter, exit and re-enter treatment at any point along the continuum. Some preventive rehabilitation may be initiated in the Intensive Care Unit such as body positioning, splinting, and range of motion (a therapist moves the person’s limbs). During acute rehabilitation, a team of health professionals with experience and training in brain injury work with the patient to regain as many activities of daily living as possible. Rehabilitation channels the body's natural healing abilities and the brain's relearning processes so an individual may recover as quickly and efficiently as possible.
Subacute programs may also be designed for persons who have made progress in the acute rehabilitation setting and are still progressing but are not making rapid functional gains. The physiatrist works with the rehabilitation team, the person with a brain injury, and the family to develop the best possible treatment plan. Functional goals include increasing independent ability with walking, getting in and out of bed, on and off a toilet, or in and out of a bathtub.
The occupational therapist also fabricates splints and casts to reduce deformities and optimize muscle functioning.
A rehabilitation nurse is responsible for the assessment, implementation, and evaluation of each individual patient's nursing care and educational needs based on specific problems as well as coordinating with physicians and other team members to move the patient from a dependent to an independent role. Additional programs provided by recreational therapists may include pet therapy, leisure education, wheelchair sports, gardening, special social functions or holiday functions for persons and their family. The neuropsychologist’s evaluations provide valuable information to assist with school, community, or employment re-entry. The ultimate goal is to increase the person’s functional ability with activities of daily living.
He has gross attention to the environment, but is highly distractible and lacks ability to focus attention to a specific task without frequent re-direction back to it. He follows simple directions consistently and shows carry-over for tasks he has relearned (as self-care). He has superficial awareness of, but lacks insight into, his condition, decreased judgment and problem-solving and lacks realistic planning for his future. Within his physical capabilities, he is independent in home and community skills, including driving.
Brain injury support groups are also a good place to network and learn what others have done in similar situations. For most people constipation is a discomfort that's best not discussed as it is in most cases temporary and for most people it's an awkward subject.
In most cases however an individual is said to suffer from constipation if there is straining to pass stools most of the time, if stools are hard most of the time, if the bowels are not completely evacuated a lot of the time and if bowel movements occur just once or twice a week. In almost all cases the main cause of constipation is a poor diet or dehydration, but it may also be caused due to certain medications.
To tackle severe constipation you need a combination of dietary and lifestyle changes to really make an impact on your bowel movements.
Studies have supported some of these claims and defatted flaxseed meal was found to help in the treatment of constipation.
Senna should not be used for long periods of time and as with any herbal treatment should be taken under the supervision of a trained specialist.
Some people may experience cramping or diarrhea with aloe vera juice so proceed with caution.


If fresh grapes are unavailable, raisins soaked overnight in water are the next best alternative. Deep breathing exercises and meditation also help relieve stress and anxiety that may be causing the constipation.
Many experience sore throat and is said to be caused by the Streptococcus spp bacteria or Group A Streptococcus bacteria or Streptococcus pyogenes. If one is not cured after 3 to 4 days of treatment, seeking the doctor’s assistance is very much needed.
Giving of analgesics such as NSAIDs (non-steroidal anti-inflammatory drugs) can relieve the discomfort the patient is experiencing. Rehabilitation also involves learning new ways to compensate for abilities that have permanently changed due to brain injury. Physical therapists provide training with assistive devices such as canes or walkers for ambulation.
He may follow simple commands in an inconsistent, delayed manner such as closing his eyes, squeezing or extending an extremity. He may cry out or scream out of proportion to stimuli even after removal, show aggressive behavior, attempt to remove restraints or tubes, or crawl out of bed in a purposeful manner. He is at least supervised with old learning; unable to maximally be assisted for new learning with little or no carry-over. Vocational rehabilitation, to determine ability to return as contributor to society (perhaps in a new capacity) is indicated.
Later, it was used as a quick and effective anesthetic in emergency rooms and veterinary clinics. If the problem is severe or frequent and causes you a great deal of discomfort however it is important that you discuss it with your health care provider. In some cases, constipation may also be a symptom of an underlying medical condition such as IBS or Irritable Bowel Syndrome. If you prefer herbal or natural remedies for constipation, make sure you check with your doctor before trying anything new. Fiber supplements such as Metamucil can help, but make sure you drink enough water when taking such supplements or it could worsen the situation. Tendency is that their strep throat presentation is much worse than to those who are healthier. Aspirin is given to patients but not recommended to children for their risk to develop a condition called Reye’s syndrome. The close proximity between an infected person and uninfected person can be also a source of transmission. Physical therapists can also use physical modalities, treatments of heat, cold, and water to assist with pain relief and muscle movement.
He does not, however, discriminate among persons or objects and is unable to cooperate directly with treatment efforts.
His memory is severely impaired, with confusion of past and present in his reaction to ongoing activity. Responses may be incorrect due to memory problem, but they are appropriate to the situation.
He may continue to show a decreased ability, relative to premorbid abilities, in abstract reasoning, tolerance for stress, judgement in emergencies or unusual circumstances.
The US military used ketamine as a field anesthetic during the Vietnam War.Traditional anti-depressants, selective serotonin reuptake inhibitors (SSRIs), typically take three to eight weeks to show any results and because different SSRIs have different chemical recipes, not all of them are effective for all patients.
In most cases dietary and lifestyle modifications alone suffice and there is no real need for medical treatment.
Also keep in mind, an overuse of herbal supplements can reduce their efficacy in the long run. For some people, suddenly adding high amounts of fiber into their diet may cause gas and bloating. These bacteria are also known not only to affect our throats but as well as the skin causing impetigo. This is a more convenient test as this can be quicker, results can be attained in minutes, compared to throat culture. Toxic shock syndrome is a very rare complication and is due to the causative agent Group A Streptococcus.
Antibiotics are very essential in treating strep throat especially the causative agent Streptococcus spp. Another action is by covering the mouth and nose when sneezing or coughing needs to be followed by the infected person. Exposure to the Streptococcus spp can have a sudden reaction and may start to develop in a short time after. Treatment methods and technologies are rapidly advancing as knowledge of the brain and its function increases.
He may also show a vague awareness of self and body by responding to discomfort by pulling at nasogastric tube or catheter or resisting restraints. Patient lacks initiation of functional tasks and often shows inappropriate use of objects without external direction.
They may be delayed to immediate and he shows decreased ability to process information with little or no anticipation or prediction of events. He is independent in self-care activities and supervised in home and community skills for safety.
His social, emotional, and intellectual capacities may continue to be at a decreased level for him, but functional in society. The payoff with SSRIs is too far away and, in the end, often turns to dust.Ketamine, however, can kick in within hours. If this is the case, try introducing small amounts of fiber at a time until the digestive system gets used to it. A positive result is concluded once the throat culture or RADT along with all the presenting symptoms are identified. Once antibiotics are given in an early date of the infection, the spreading of the bacteria is avoided. He may show a bias toward responding to some persons (especially family, friends) but not to others. He may be able to perform previously-learned tasks when structured for him, but is unable to learn new information. With structure, he is able to initiate tasks as social or recreational activities in which he now has interest.
However, these types of laxatives are not suitable for long-term use and can result in an electrolyte imbalance in the body and dehydration. This drug therapy is very much recommended for this can also avoid progression of complications. Thus, gross attention to environment is very short and selective attention is often nonexistent.Being unaware of present events, patient lacks short-term recall and may be reacting to past events. The patient may show beginning immediate awareness of situation by realizing he doesn't know an answer. The dose is less than when the drug is used as an anesthetic and low enough not to lead to addiction. If the constipation has been caused by an illness or as a side effect of surgery, stool softeners are usually prescribed to help make the bowel movement less painful.
Giving of penicillin is done as a one-time treatment for to attain immediate relief from strep throat. The patient can usually perform self-care activities, with assistance, and may accomplish feeding with maximum supervision. Saline or mineral oil enemas are more aggressive cures for constipation and should not be used on a regular basis. Cephalosporins and macrolides are also given to patients who are found allergic to penicillin.
If not disabled physically, he may perform motor activities such as sitting, reaching, and ambulating, but as part of his agitated state and not as a purposeful act or on request, necessarily.
Management on the ward is often a problem if the patient is physically mobile, as he may wander off, either randomly or with vague intentions of "going home".
Selective attention to task may be impaired, especially with difficult tasks and in unstructured settings, but is now functional for common daily activities (30 min. Home remedies for constipation in toddlers and children generally involve the use of suppositories.
Glycerin suppositories are inserted into the rectum and soften stools and make them easier to pass. He may show a vague recognition of some staff, has increased awareness of self, family and basic needs (as food), again, in an appropriate manner as in contrast to Level V.




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