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Severe Acute Brain Injury

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Neuropalliative Care

Abstract

Severe acute brain injury (SABI) is a heterogeneous group of diseases that leave patients acutely neurologically devastated. This chapter discusses the unique challenges that clinicians face when caring for patients with SABI and their families with a focus on the acute setting, when shared decision making is challenged by significant prognostic uncertainty and the need for grieving family members to consider patient’s goals of care. Clinicians practicing in the emergency department, acute neurology or neuro-critical care setting need to master a set of distinct palliative care skills to help patients and families navigate the severe acute brain injury landscape. These skills are relevant to all clinicians, providing both primary and specialist palliative care. Using a case example, we provide recommendations regarding symptom management and caregiver support in the acute and chronic setting, and discuss communication skills for clinicians engaging with family members, especially around prognosis and treatment goals. Research and education needs in this area of palliative care are substantial.

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Author information

Authors and Affiliations

  1. Department of Medicine, and Palliative Care Service, University of Washington School of Medicine/Harborview Medical Center, Seattle, WA, USA

    Margaret Isaac MD

  2. Department of Neurology, University of Washington Harborview Medical Center, Seattle, WA, USA

    Claire J. Creutzfeldt MD

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  1. Margaret Isaac MD
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  2. Claire J. Creutzfeldt MD
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Correspondence to Margaret Isaac MD .

Editor information

Editors and Affiliations

  1. Assistant Professor, Department of Neurology, University of Washington Harborview Medical Center, Seattle, WA, USA

    Claire J. Creutzfeldt

  2. Professor of Neurology, Chief Neurology Supportive and Palliative Care Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Benzi M. Kluger

  3. Professor and Edward A. and Alma Vollertsen Rykenboer Chair, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

    Robert G. Holloway

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Isaac, M., Creutzfeldt, C.J. (2019). Severe Acute Brain Injury. In: Creutzfeldt, C., Kluger, B., Holloway, R. (eds) Neuropalliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-93215-6_2

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  • DOI: https://doi.org/10.1007/978-3-319-93215-6_2

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