Mngmt of Neuro

The amount of immediate damage from the impact of the brain injury.

Damage from the systemic and intracranial mechanisms that occur after the initial injury

No response to any stimulation.
(Rancho Los Amigos Scale)

- Non-purposeful and inconsistent response to any stimilus.
- Responses the same regardless of type or location of stimulation.
- Reflexive in nature.
(Rancho Los Amigos Scale)

- Response directly to type of stimulus but inconsistent.
- Ex: blinks when strong light crosses visual field, pulls at tubes and restraints that are uncomfortable.

Treatment focuses on:
- maintaining functional ROM
- positioning
- facilitating any kind of movement
- family education
- upright positioning - sitting, tilt table

- Increased level of activity.
- Non-purposeful behaviors.
- Inappropriate or incoherent speaking.
- Cries/screams out of proportion to stimulus.
- May be aggresive or exhibit flight behavior.
- No short term or long term memory.
(Rancho Los Amigos Scale)

Treatment focuses on:
- maintaining any functional abilities: usually more automatic, previously aquired abilities.
- may try to add functional tasks depending on physical ability of the patient.

- Gross attention to environment but easily dstracted without a structured environment.
- Responds to simple commands and performs previously learned tasks.
- Difficulty with complex tasks, responses non-purposeful and random.
(Rancho Los Amigos Scale)

- Past memory shows more depth and detail.
- Goal directed behavior but needs structure and direction.
- Consistently appropriate response to simple directions.
- Shows carryover for relearned tasks.
(Rancho Los Amigos Scale)

Treatment focus:
- Can add more formal and specific treatment for motor deficits that interfere with mobility.
- Still important to maintain structure and decrease stress to increase level of performance.