The “ coma sign” : An iatrogenic complication of neurological assessment

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Lucke Wold Brandon; Robinson DO Christopher

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Journal Paper

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Journal: Current Journal of Neurology Year:2019 | Volume:18 | Issue:1 Page(s): 41-42

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Title

The “ coma sign” : An iatrogenic complication of neurological assessment

Author(s)

Lucke Wold Brandon | Robinson DO Christopher | Issue Writer Certificate

Keywords

Coma

Sternal Rub

Supraorbital Pressure

Neurological Assessment

Abstract

Acute brain injury is a commonly encountered clinical problem that can make appropriate clinical assessment challenging. A key limitation in the neurological intensive care unit is how examiners assess a patient’ s level of arousal or responsiveness. The vast majority of providers are trained to use either nail bed pressure or a Sternal Rub technique to achieve such responses. While these noxious stimuli do elicit findings in non-Comatose patients, Comatose patients may be exposed to unnecessary harm with these techniques. In fact, reports in the literature have shown that Sternal Rubbing causes iatrogenic complications including skin tears, abrasions, and ecchymosis. 1 Such consequences should be considered during formal Neurological Assessment. Here, we present a case of repetitive noxious stimuli leading to diffuse sternal bruising, which the authors formally refer to as the “ Coma sign” (Figure 1)...

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APA: Copy

Lucke Wold, Brandon, & Robinson DO, Christopher. (2019). The “ coma sign” : An iatrogenic complication of neurological assessment. CURRENT JOURNAL OF NEUROLOGY (IRANIAN JOURNAL OF NEUROLOGY), 18(1), 41-42. SID. https://sid.ir/paper/764008/en

Vancouver: Copy

Lucke Wold Brandon, Robinson DO Christopher. The “ coma sign” : An iatrogenic complication of neurological assessment. CURRENT JOURNAL OF NEUROLOGY (IRANIAN JOURNAL OF NEUROLOGY)[Internet]. 2019;18(1):41-42. Available from: https://sid.ir/paper/764008/en

IEEE: Copy

Brandon Lucke Wold, and Christopher Robinson DO, “The “ coma sign” : An iatrogenic complication of neurological assessment,” CURRENT JOURNAL OF NEUROLOGY (IRANIAN JOURNAL OF NEUROLOGY), vol. 18, no. 1, pp. 41–42, 2019, [Online]. Available: https://sid.ir/paper/764008/en

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