prolonged inspiratory and expiratory phases due to injury of the pons or upper medulla
Cluster respirations
Periods or clusters of rapid respirations of nearly equal depth, due to trauma or
compression of the medulla or to chronic opioid abuse
ataxic respirations
labored, irregular respirations with periods of apnea due to damage to the medulla
Confusion
Decreased ability to think rapidly and clearly; inability to make judgment and decisions
disorientation
Confusion-altered state of consciousness; initial loss of orientation to time, then to
place, with some memory impairment; ability to recognize self is lost last
Somnolence
Some spontaneous movement or talking; can be easily awakened; speech and touch
typically can awaken the patient, although he or she may not orient to time, place, or
person
Obtundation
Mild to moderate decrease in level of consciousness with minimal responsiveness to the
environment; sleeps unless verbosity or tactically aroused; responds to questions, but
responses are minimal
, Stupor
Condition of deep sleep or unresponsiveness from which person may be aroused or
caused to open eyes only by vigorous and repeated stimulation; response is often
withdrawal or grabbing at stimulus
Coma
No verbal response to the external environment or to any stimuli; noxious stimuli such as
deep pain or suctioning yields motor movement
Light coma
Associated with purposeful movement on stimulation
Deep coma
Associated with unresponsiveness or no response to any stimulus
Pupillary changes: ischemia/hypoxia
dilated and fixed pupils
Pupillary changes: opiates
pinpoint pupils
Brain death (total brain death)
• Body cannot maintain internal homeostasis.
• The entire brain, including brainstem and cerebrum, has irreversibly ceased to
function.
Brain death criteria
All pertinent diagnoses and treatments have been completed
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