485 and facesheets

[smartnurse1982]

Ok,so I had a question on the general nursing discussion and fell bad for asking it.In any event,I now know some of my pts aren't "brain dead" but they might be in a persistant vegetative state.I have never,ever seen that on any of the facesheets and 485.Meanwhile,I don't really know if the kids are in a vegetative state.Some of the kids I wokr with have no purposeful movements,their pupils don't react with light,have no spontaneous respirations,and are unresponsiveto external stimuli. Most have aw/as cycles.The only thing I've seen are "global developmental delays".It isn't asking the same question as I asked in the general forum,but how would you describe in under "Neurological" on the assessment sheets? Also,how do you describe it under "activity" on the assessment sheets? I just put either Aw or As.Its frustrating to have to explain to Emt's sometimes what's going on......

[smartnurse1982]

I'm not charting vegetative state or anthing like that.My pts open and close their eyes;that's it.None have an official diagnosis of "coma" and rightly so,because they do open and close the eyes. Of the 4 agencies I've worked with,most told me to document aw/as cycles under activity.

[Esme12, ASN, BSN, RN]

I am not an expert in home health or private duty....so I would follow your companies instructions. As a nurse who has done home health/private duty to a chlkd on a vent I never charted aw/as under activity. I just always document what I see.

[smartnurse1982]

I think I'm going to start putting that.For most cases,I just put the diagnosis under neuro,but aw/as cycles under activity.We have a thread on this in this forum. I've got to search it up.

[KelRN215, BSN, RN]

I always thought "Global Developmental Delay" meant something similiar to a "vegetative state" but wasn't sure.

Global developmental delay means NOTHING similar to a vegetative state. Children with global delays may walk and talk but they are delayed in that their abilities are not on par to their peers/developmental milestones. A one year old who can't roll over, sit, crawl, pull to stand and has no words would be "globally developmentally delayed" but could have totally normal level of consciousness.

One of my 3 year old patients who has CP cannot stand or walk but can crawl and she only speaks in 1-2 word phrases. She is globally developmentally delayed but she is- in no way- in a vegetative state.