Understanding reality

Altered

Consciousness

THE STATE OF BEING AWARE OF AND RESPONSIVE TO ONE'S SURROUNDINGS.

A PERSON'S AWARENESS OR PERCEPTION OF SOMETHING.

Awareness and perception?

The aim of this session

How does this help you as a nurse?

Is to define consciousness

Is to define altered

consciousness

To understand the causes of

altered consciousness

• Magical: Hypnosis

• Spiritual: Meditation

• Simple on the surface

• Complex to prove

• Levels of consciousness

• Sleep; Dream

Consciousness: Assessment (William Jones)

The Stream of Consciousness

Awake Not Awake? Sleep

• Arousal (internal or external)

• Eye Opening

• Orientated (Time Place Person)

• Response ( Pain Sound Light Smell Taste)

• Perception (Understanding)

• The Self ( awareness thinking feeling)

Subjective: The Reality of Individuals

https://www.youtube.com/watch?v=jl3B8_qKmFQ

Reticular Activating System

Consciousness

Relates to awareness of thoughts feeling perceptions surroundings at any one moment in time…This creates reality

Altering Consciousness

Drugs Trauma Sleepillness

Disease Anasthesia

BarbituatesValiumBenzidazpine LorazepamOpiodsCaffineAlcoholAnesthetics: local infiltration, regional nerve blocks, and topical administrationPropofol (Diprivan): short-acting hypnotic;

Conscious Altering Drugs

Conscious sedation/analgesia is combinations of pharmacological agents administered by one or more routes to produce a minimally depressed level of consciousness and satisfactory analgesia while retaining the ability to independently and continuously maintain an airway and respond to physical stimulation and verbal commands.

Normal Self Induced Altered Consciousness

Sleep http://youtu.be/rMHus-0wFSo

HTTP://VISUALISEUR.BNF.FR/VISUALISEUR?DESTINATION=GALLICA&O=NUMM-98765

Neurotransmittors

• Serotonin • Nor ephinephrine• Dopamine• Gamma Aminobutyric (GABA)

The Awakenings: Dopamine

The Glasgow Coma ScaleJennette and Teasdale (1974)

Measuring Consciousness

Motor Response

Eye Opening

Motor Response

Generally, brain injury is classified as:• Severe, with GCS < 8-9• Moderate, GCS 8 or 9–12 • Minor, GCS ≥ 13.

»Oliver Sacks

»William Jones

Key Authors: References

Teasdale G, Jennett B. (1974). "Assessment of coma and impaired consciousness. A practical scale.". Lancet 13 (2): 81–4.

http://www.tandfonline.com/doi/abs/10.1080/09515080902802850#.VOJS5yivJUQ

http://www.ncbi.nlm.nih.gov/pubmed/12006123

http://dictionary.reference.com/browse/consciousness