Learning Scenarios: ABI

This scenario is based knowledge of a 3rd year/rotational level Band 5

Acquired Brain Injury

CASE 1:

A 30 year old man acquired a brain injury a week ago and is ventilated in ICU.  His conscious levels tend to fluctuate.

Tasks on model:

  • Perform an auscultation and explain to the examiner which lobe are you listening to and what you are listening for.
  • Discuss ABG’s and normal values.
  • Teach your patient active cycle breathing technique.
  • Discuss a further treatment technique to help him clear secretions.
Hints and tips Hints and tips

It may be useful to teach a member of his family ACBT to enable them to prompt him should he forget.

CASE 2:

A lady acquired a brain injury 3 weeks ago. She is progressing well and is able to tolerate postural seating for 20minutes. Your assessment identifies low tone in anti gravity positions.

Tasks on the model:

  • Demonstrate how you would transfer this patient onto a tilt table. .
  • Describe how you would progress the tilt to give the patient time to adjust.
  • What clinical signs would you be looking for which may indicate a drop in blood pressure? How would you assess this and list normal ranges.
Hints and tips Hints and tips

How many people do you need to make this safe?

Case 3

A 25 year old woman acquired a brain injury three weeks ago. She is progressing with exercises on a tilt table.

Tasks on model:

  • Recommend 3 tasks/exercises that could be carried out on the tilt table to address head control.
  • Describe how you would change the exercises depending on the patients level of ability.
  • Describe 3 exercises that could help to adress trunk control?
Hints and tips Hints and tips

What observations would you need to keep in mind to monitor patients response to treat?

Be aware of signs of fatigue?

Do you have enough people to make the task safe?

Thoracic Spine   Acquired Brain Injury    Upper Limb    Lower Limb

 

 

Tables can be useful when gathering your thoughts and  building a record of your revision. The table below offers a framework and a check list.  Reflection and constructive criticism from a colleague will help improve your performance. By familiarising yourself with the routine of an examination will help reduce nerves within the exam.

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