Top Ten Tips Palliative Care Clinicians Should Know About Disorders of Consciousness: A Focus on Traumatic and Anoxic Brain Injury

J Palliat Med. 2022 Oct;25(10):1571-1578. doi: 10.1089/jpm.2022.0202. Epub 2022 May 30.

Abstract

Palliative care (PC) teams commonly encounter patients with disorders of consciousness (DOC) following anoxic or traumatic brain injury (TBI). Primary teams may consult PC to help surrogates in making treatment choices for these patients. PC clinicians must understand the complexity of predicting neurologic outcomes, address clinical nihilism, and appropriately guide surrogates in making decisions that are concordant with patients' goals. The purpose of this article was to provide PC providers with a better understanding of caring for patients with DOC, specifically following anoxic or TBI. Many of the tips acknowledge the uncertainty of DOC and provide strategies to help tackle this dilemma.

Keywords: anoxic brain injury; cardiac arrest; disorders of consciousness; palliative care; prognostication; traumatic brain injury.

MeSH terms

  • Brain Injuries, Traumatic* / complications
  • Consciousness
  • Decision Making
  • Hospice and Palliative Care Nursing*
  • Humans
  • Palliative Care