Severe Traumatic Brain Injury

Published

Specializes in LTC, Dementia/Alzheimer's.

I have a pt who suffered a severe traumatic brain injury 6 years ago via electrocution.

He is comatose for all practical purposes. He can't communicate. Sometimes he smiles, laughs, etc, but I'm unsure if he comprehends situations/language.

He often moans, yells (q few minutes). His family is concerned with this behavior and they ask WHY he's yelling. I don't know what to tell them... I believe it's due to extensive brain damage and the progressive degeneration of brain tissue, but I was instructed by another nurse to not tell the family this.

He storms and has seizures throughout the shift also. This pt is new to me. I just finished training for this case. Tonight will be my first night alone with him. It's pretty simple; GT meds, VS, turn q2hr, and not much else... Sit on my ass and watch TV. The only thing I'm worried about is the family.

What would you say when the family asks about the yelling?

Up Vote Up Vote ×
Specializes in Acute post op ortho.

Tell them that with a brain injury of this magnitude, it's difficult to know the cause of his vocalizations.

Could he be responding to noise or light? The only way to know will be to observe him over time. Even then, it will only be a guess on your part.

I'm sure the family is upset with the thought of their loved possibly being in pain, or trying to communicate, and not being understood.

I had a patient ages ago with TBI, he hallucinated quite a bit. I found playing soothing music helped to calm him when nothing else helped.

His family ended up going with me to a music store.....they liked it too.

Up Vote Up Vote ×
Specializes in LTC, Dementia/Alzheimer's.

He yells in light, dark, quiet, noise, dirty, clean, back, either side, chair, bed, in the hoyer, in the shower, etc.

Always yells. No rhyme or obvious reason that I can see. There's another nurse that's been with him for 5 1/2 years, she says he's always done it..

But I like that answer. A better way of saying "I don't know." I always hate saying I don't know, even though ... that's the answer to a lot of family questions I've been getting lately.

Up Vote Up Vote ×
+ Join the Discussion