International survey on the implementation of the European and American guidelines on disorders of consciousness [Elektronisk resurs]

• Diagnostic, prognostic, and therapeutic procedures for patients with prolonged disorders of consciousness (pDoCs) vary significantly across countries and clinical settings, likely due to organizational factors (e.g., research vs. non-academic hospitals), expertise and availability of resources (e.g., financial and human). Two international guidelines, one from the European Academy of Neurology (EAN) and one from the American Academy of Neurology (AAN) in collaboration with the American Congress of Rehabilitation Medicine (ACRM) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), were developed to facilitate consistent practice among professionals working with this challenging patient population. While the recommendations of both guidelines agree in principle, it remains an open issue how to implement them into clinical practice in the care pathway for patients with pDoCs. We conducted an online survey to explore health professional clinical practices related to the management of patients with pDoCs, and compare said practices with selected recommendations from both the guidelines. The survey revealed that while some recommendations are being followed, others are not and/or may require more honing/specificity to enhance their clinical utility. Particular attention should be given to the implementation of a multimodal assessment of residual consciousness, to the detection and treatment of pain, and to the impact of restrictions imposed by COVID-19 pandemics on the involvement of patients’ families/representatives. 

Ämnesord

Medical and Health Sciences  (hsv)

Clinical Medicine  (hsv)

Neurology  (hsv)

Medicin och hälsovetenskap  (hsv)

Klinisk medicin  (hsv)

Neurologi  (hsv)

Humanities and the Arts  (hsv)

Philosophy, Ethics and Religion  (hsv)

Ethics  (hsv)

Humaniora och konst  (hsv)

Filosofi, etik och religion  (hsv)

Etik  (hsv)

Clinical Neurophysiology  (uu)

Klinisk neurofysiologi  (uu)

Neurology  (uu)

Neurologi  (uu)

Medicinsk vetenskap  (uu)

Medical Science  (uu)

Genre

government publication  (marcgt)

Indexterm och SAB-rubrik

Coma

Disorders of consciousness

Vegetative states

Unresponsive wakefulness syndrome

Minimally conscious state

Cognitive–motor dissociation

Neuroethics

Bioethics

Ethics

Clinical guidelines