12-29-2008, 11:56 AM
A 64-year-old woman is transferred to a chronic care facility 8 weeks after a cardiac arrest. The arrest occurred when she was at a restaurant and suddenly lost consciousness. When paramedics arrived 5 minutes later, she had no heartbeat or pulse and required 35 minutes of resuscitation before sinus rhythm returned. Since her cardiac arrest, she has remained unresponsive, without any response to commands; 3 weeks after the arrest, she began to have return of sleep“wake cycles.
On examination today, she has a tracheostomy in place but is not on a ventilator and breathes well spontaneously. She occasionally yawns. Pupils are equal and reactive to light. Her eyes are open; she has spontaneous conjugate movements of her eyes to either side but does not appear to track objects or look at the examiner. She flexes her arms to noxious stimuli, but has no evidence of any purposeful or voluntary response to visual, auditory, or tactile stimuli.
Which of the following is the most appropriate description of this patient's condition?
A Brain death
B Locked-in syndrome
C Minimally conscious state
D Persistent vegetative state
E Permanent vegetative state
On examination today, she has a tracheostomy in place but is not on a ventilator and breathes well spontaneously. She occasionally yawns. Pupils are equal and reactive to light. Her eyes are open; she has spontaneous conjugate movements of her eyes to either side but does not appear to track objects or look at the examiner. She flexes her arms to noxious stimuli, but has no evidence of any purposeful or voluntary response to visual, auditory, or tactile stimuli.
Which of the following is the most appropriate description of this patient's condition?
A Brain death
B Locked-in syndrome
C Minimally conscious state
D Persistent vegetative state
E Permanent vegetative state