Memory loss of the events near the time of a loss of consciousness may or may n ot return, depending upon the

severity of the injury. It is not uncommon for the se memories to return over the ensuing days to wee s. ** Alcohol poisoning is a serious and sometimes deadly consequence of drin ing larg e amounts of alcohol in a short period of time. Drin ing too much too quic ly ca n affect your breathing, heart rate and gag reflex and potentially lead to coma and death. Binge drin ing rapidly downing five or more drin s in a row is a main cause of a lcohol poisoning. Alcohol poisoning can also occur when you accidentally or inte ntionally drin household products that contain alcohol. A person with alcohol poisoning needs immediate medical attention. If you suspec t someone has alcohol poisoning, call for emergency medical help right away. Alcohol poisoning treatment consists of providing breathing support and intraven ous fluids and vitamins until the alcohol is completely out of the body ******* What Is Alcohol Poisoning? How Dangerous Is Alcohol Poisoning? Editor's Choice Main Category: Alcohol / Addiction / Illegal Drugs Article Date: 03 Feb 2011 - 0:00 PDT email icon email to a friend ns printer icon printer friendly write icon opinio

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When a person has alcohol poisoning they have consumed a toxic amount of alcohol , usually over a short period. Their blood alcohol level is so high it is consid ered toxic (poisonous). The patient can become extremely confused, unresponsive, disoriented, have shallow breathing, and can even pass out or go into a coma. A lcohol poisoning can be life-threatening and usually requires urgent medical tre atment. Binge drin ing is a common cause of alcohol poisoning. However, it can also occu r accidentally, as when somebody unintentionally drin s alcohol-containing house hold products (much less common). When somebody consumes an alcoholic drin , their liver has to filter out the alc ohol, a toxin, from their blood. We absorb alcohol much more quic ly than food alcohol gets to our bloodstream much faster. However, the liver can only proces s a limited amount of alcohol; approximately one unit of alcohol every hour. If you drin two units in one hour, there will be an extra unit in your bloodstr

eam. If during the next hour you drin another two units, you will have two unit s floating around in your bloodstream at the end of two hours after your drin in g session. The faster you drin , the higher your BAC (blood alcohol concentratio n) becomes. If you drin too fast, your BAC can spi e dangerously high. Rapid drin ing can bring your BAC so high that your mental and physical function s become negatively affected. Your breathing, heartbeat and gag reflex - which a re controlled by types of nerves - might not wor properly. You become breathles s, you may cho e, and your heart rhythm might become irregular. If your BAC is h igh enough, these physical functions can stop wor ing, the patient stops breathi ng and passes out (loses consciousness). In the USA approximately 50,000 cases of alcohol poisoning are reported annually . About one patient dies each wee in the USA from alcohol poisoning. Those at highest ris of suffering from alcohol poisoning are college students, chronic alcoholics, those ta ing medications that might clash with alcohol, and sometimes children who may drin because they wish to now what it is li e. What are the signs and symptoms of alcohol poisoning? Even when you stop drin ing, your BAC can continue rising for up to thirty to fo rty minutes, resulting in worsening symptoms if you have already consumed a lot.

Confusion Hypothermia (the person's body temperature drops) Pale s in, sometimes it may ta e on a bluish tinge The individual is unresponsive but conscious (stupor) The individual passes out Unusual breathing rhythm Very slow breathing Vomiting ******** TBI is a major cause of death and disability worldwide, especially in children a nd young adults. Males sustain traumatic brain injuries more frequently than do females. Causes include falls, vehicle accidents, and violence. Prevention measu res include use of technology to protect those suffering from automobile acciden ts, such as seat belts and sports or motorcycle helmets, as well as efforts to r educe the number of automobile accidents, such as safety education programs and enforcement of traffic laws. Brain trauma can be caused by a direct impact or by acceleration alone. In addit ion to the damage caused at the moment of injury, brain trauma causes secondary injury, a variety of events that ta e place in the minutes and days following th e injury. These processes, which include alterations in cerebral blood flow and the pressure within the s ull, contribute substantially to the damage from the i nitial injury. TBI can cause a host of physical, cognitive, social, emotional, and behavioral e ffects, and outcome can range from complete recovery to permanent disability or death. The 20th century saw critical developments in diagnosis and treatment tha t decreased death rates and improved outcome. Some of the current imaging techni ques used for diagnosis and treatment include CT scans computed tomography and M RIs magnetic resonance imaging. Depending on the injury, treatment required may be minimal or may include interventions such as medications, emergency surgery o r surgery years later. Physical therapy, speech therapy, recreation therapy, occ upational therapy and vision therapy may be employed for rehabilitation.

The following signs and symptoms may indicate a progression from being drun alcohol poisoning:

to

********* Treatment It is important to begin emergency treatment within the so-called "golden hour" following the injury.[81] People with moderate to severe injuries are li ely to receive treatment in an intensive care unit followed by a neurosurgical ward.[82 ] Treatment depends on the recovery stage of the patient. In the acute stage the primary aim of the medical personnel is to stabilize the patient and focus on p reventing further injury because little can be done to reverse the initial damag e caused by trauma.[82] Rehabilitation is the main treatment for the subacute an d chronic stages of recovery.[82] International clinical guidelines have been pr oposed with the aim of guiding decisions in TBI treatment, as defined by an auth oritative examination of current evidence.[2] ********** Brain Injury: Understanding Coma Coma is common with severe brain injuries, especially injuries that affect the a rousal center in the brain stem. Understanding coma can be difficult because the re are many levels of coma. In general, coma is a lac of awareness of one s self an d what is around one. A person in a coma can t sense or respond to the needs of hi s body or his environment. A person in a coma: May or may not have their eyes closed all the time. Cannot communicate. Cannot move in a purposeful way, such as following instructions li e and, or open your eyes.

Because their eyes may be closed, many of us thin of someone in a coma as being asleep. The difference is that you can get someone to open their eyes when the are asleep. But you can t get someone in a coma to open their eyes. Their eyes are closed because the normal sleeping and wa ing pattern has been disrupted. (Some times the eyes are taped shut to protect them from injury and drying out.) They cannot follow directions or communicate because their brain doesn t process i nformation the way it used to. It is also common for breathing and blood pressur e to be affected; if so, proper care will be needed to help control breathing or blood pressure for them. There is no set pattern of recovery from coma, but there are signs that may mean improvement (coming out of a coma). Signs of coming out of a coma include being able to eep their eyes open for longer and longer periods of time and being aw a ened from sleep easier at first by pain (pinch), then by touch (li e gently sha in g of their shoulder), and finally by sound (calling their name). Emerging From Coma and Signs of Improvement Not everyone who has a brain injury emerges from a coma. If they do, they may fo llow a common pattern. Emerging from a coma is not li e wa ing up from regular s leep. When your loved one first starts to wa e up from or come out of the coma, he may n ot be able to focus his eyes. He may or may not be able to respond to you. He ma y loo as if he is staring off into space. Part of this is from the injury; part of it may be from medicine. Movement can be another sign of improvement. At fir st, movements may be random li e flailing arms, then may progress to semi-purpos eful (such as pulling at tubes) and possibly moving in response to instructions ( Squeeze my hand. ). The patient s awareness of self and his surroundings increases a s he improves and gets better.

squeeze my h

Visual and auditory trac ing is another sign of improvement following sights and s ounds. Trac ing is when your loved one watches you as you move around the room o r turns their head toward you when they see you or hear your voice. The next stage of improvement is when your loved one begins to follow some comma nds intermittently and is also consistently trac ing sights and sounds. Followin g commands intermittently means they won t squeeze your hand every time you as . As they get better, they will follow commands more regularly. **************** Post-traumatic amnesia From Wi ipedia, the free encyclopedia Jump to: navigation, search Post-traumatic amnesia (PTA) is a state of confusion that occurs immediately fol lowing a traumatic brain injury (TBI) in which the injured person is disoriented and unable to remember events that occur after the injury.[1] The person may be unable to state his or her name, where he or she is, and what time it is.[1] Wh en continuous memory returns, PTA is considered to have resolved.[2] While PTA l asts, new events cannot be stored in the memory.[3] About a third of patients wi th mild head injury are reported to have "islands of memory", in which the patie nt can recall only some events.[3] During PTA, the patient's consciousness is "c louded".[4] Because PTA involves confusion in addition to the memory loss typica l of amnesia, the term "posttraumatic confusional state" has been proposed as an alternative.[4] There are two types of amnesia: retrograde amnesia (loss of memories that were f ormed shortly before the injury) and anterograde amnesia (problems with creating new memories after the injury has ta en place).[5] Both retrograde and anterogr ade forms may be referred to as PTA,[6] or the term may be used to refer only to anterograde amnesia.[7] ******* The rehabilitation process begins while the patient is still in a coma. This early intervention increases the possibility of maximum recovery--- medical ly, physically, cognitively and psychologically. For example: The physical therapist will wor with the comatose patient helping to preserve muscle tone and mobility. The speech therapist will wor on the swal low function, which may be impaired. Rehabilitation nurses will test for respons e from the patient. The respiratory therapist also plays an important part in the early stages of re habilitation. There are a number of different ways that the respiratory therapist is involved in the rehabilitation of the brain injured patient. More often then not the brai n injured patient will have been maintained on life support for a good deal of t ime and this causes some other difficulties that must be managed after the patie nt is weaned from the mechanical ventilator: 1) Training must be provided to the patient/family in maintaining the patien t's tracheostomy tube (which most severely brain injured patient's acquire due t o the length of time that he/she is on mechanical ventilation) including learnin g how to suction the patient and changing the dressing and cleaning the tube. 2) The respiratory therapist will often provide pulmonary hygiene to eep th e patient free from pulmonary problems such as pneumonia or atelectasis (collaps e of the alveoli - air sacs - in the lungs). Because the patient is often less a ctive these pulmonary complications often appear in the brain injured patient an

d the respiratory therapist assists by providing breathing treatments (aerosoliz ed medication), bronchopulmonary hygiene (clapping or tapping on the bac to pro mote the movement of secretions in the lungs) and suctioning of the patient. 3) Assistance in swallowing retraining. 4) Diaphragmatic retraining. If the diaphragm (the major muscle involved in breathing) is paralyzed or wea ened the respiratory therapist can instruct the p atient on exercises to improve the function of the muscle. These are some of the areas in which the respiratory therapist assists in return ing the TBI patient to his/her previous ADL's (activities of daily living). As the patient begins to emerge from the coma, rehabilitation will begin to invo lve the patient's cooperation. Before he/she is "conscious", he/she may be encouraged to sit, or move in the be d. As the patient progresses, so will the rehabilitation. Rehabilitation should not be confused with recovery. The deficits that occur with brain injury are typically permanent. However, thro ugh rehabilitation, improvement is possible. The rehabilitation process may last several years. Occasionally the patient will reach a "plateau" or "leveling off" in improvement . It is important to continue rehabilitation as the plateau may be only a tempor ary slowdown. It was once believed that the "recovery" process was generally com pleted during the first twelve months, with very little improvement occurring af ter twelve months. It is now believed that brain injured individuals may improve over a period of several years. There are several different types of rehabilitation programs and options. The physiatrist will develop a program specifically suited to the individual. Th is program usually involves a team approach; utilizing medical personnel in seve ral different fields to address the deficits the patient may have. The goal of rehabilitation is to return the brain injured individual to a functi onal level as close to his/her pre-accident self as possible. ********** Coma: Is there anything I can do to help? Although nobody nows for sure, it is possible that patients in coma can respond to the presence of loved ones at the bedside. A familiar voice or touch may hav e a calming or reassuring effect on the patient, and certainly can't hurt. We en courage as much bedside contact between the patient and family members as is pos sible, as long as it does not interfere with medical care. Playing a patient's f avorite music may also be helpful. The main rule of thumb is to be sure that you r contact at the bedside does not lead to increased agitation, which can occur i f the patient is semi aware and frustrated by their inability to communicate or express himself or herself. If this occurs, it is probably best to leave the pat ient alone. Recovery and rehabilitation: My loved one has survived a serious neurologic inju ry. What's the next step?

Neurologic disorders cause temporary or permanent impairments that impede simple daily functions as well as complex intellectual and physical activities. Once a patient has become medically stable and all acute treatment interventions have been performed, the road toward recovery and rehabilitation can begin. Rehabilit ative measures to maximize functional recovery should begin as soon as possible after illness onset. These measures are directed toward returning the patient to as independent a lifestyle as possible. Rehabilitation may include physical, oc cupational, speech, cognitive, psychological, and vocational treatment modalitie s. These therapies serve to maximize the individual's physical strength and moto r ability, independence in performing activities of daily living (e.g. dressing, hygiene, ambulation), ability to regain financial independence, reintegration i nto their community and social networ , and promote one's psychological well-bei ng. A comprehensive rehabilitation program will include an interdisciplinary team: t he physician, physical therapist, occupational therapist, speech therapist, neur opsychologist, rehabilitation nurse, vocational counselor, and social wor er. So me patients may require intensive inpatient rehabilitation, while others may ret urn home and attend an outpatient therapy program. For individuals with more sev ere permanent disabilities, placement into a s illed nursing facility may be nec essary. Patients who do not require rehabilitation services may still benefit fr om short-term visiting nurse services to ease their transition bac home. Benefits and improvements in function are greatest within the first year after o nset of illness, although changes can continue to occur over time. An individual 's motivation and commitment to rehabilitation is clearly one of the most signif icant factors that can contribute to his or her long-term functional outcome. Recovery and rehabilitation is a family affair. It greatly impacts on the lives of the patient's primary caregiver, as well as other significant family members and friends. For the patient it is often a process of learning new ways of perfo rming old tas s, while for the caregiver it may involve adapting to and acceptin g the individual as he or she now is, which may include permanent physical and/o r cognitive limitations. Q: How do we cope after we're home from the hospital? Just as a patient must adapt to his or her current physical and intellectual lev el of function, the family must learn to adjust to these changes. There are nume rous organizations which serve as valuable clearinghouses of information for a v ariety of medical conditions. Support groups for both patients and families are excellent forums in which to secure support, understanding, and guidance during this often-stressful and challenging time. Most organizations (i.e.: MS Society, National Head Injury Foundation, etc.) often have local chapters in communities throughout the country. Libraries, telephone directories (yellow and white page s), 1-800-information, and the internet are some avenues through which to locate these organizations. There are also Federal and State agencies that provide ser vices to individuals who have permanent impairments which require accommodation in the wor place or a change in career, securing special par ing privileges or t ransportation alternatives, etc. Agencies including Independent Living Centers, Mayor's Office for the Handicapped, and Vocational and Educational Services for Individuals with Disabilities (VESID) can be contacted for information and refer ral to other assistance centers. If a family member is receiving rehabilitation services, professionals at those facilities should be able to provide other reso urces available within the community. Be your own best advocate and gather as mu ch information as you can regarding the resources available which can maximize a patient's potential to return to a fulfilling and productive life. ********** recovery from coma behaviour on emeregence from coma

post trauma amnesia