Also included are some of the most common procedures & tests carried out on patients. You should be aware of what these are, so you will be more informed and understanding when the physician talks to you later about the results. Some basic definitions related to treatments & procedures are also included, so you can understand the "medical lingo" being used by the Drs., nurses, and other professionals.

I have added my own observations, comments, etc...most from personal experience and some from Kimmie's. A LOT of people have asked me direct questions...such as "Does the trach hurt?", etc. I have tried to answer these questions in the definitions.

ADAPTIVE / ASSISTIVE EQUIPMENT
a special device which assists in the performance of self care, work, play or leisure activities.

ARTERIAL LINE
A catheter inserted into one of the arteries to measure blood pressure and the amount of oxygen and carbon dioxide in the blood. You will see this in one wrist, generally...the one with the IV Board on it. It hurts like hell when they put one in, but after that is OK as long as you don't move that extremity around too much. When they remove it, it will bleed profusely until they bandage it, so don't freak out if you are there when they do it.

BALKAN FRAME
a rectangular frame which may be placed over a hospital bed to position or increase mobility. Loops or a trapeze are often hung from the Balkan frame to assist a patient in bed activities and wheelchair transfers to and from the bed.

CENTRAL VENOUS PRESSURE (CVP) LINE
A catheter inserted into a small vein and moved to the larger vein near the heart in order to accurately measure blood pressure there ....also called a "DEEP LINE".

CHEST TUBE(S)
Tube(s) inserted between the ribs and lungs to remove air and/or fluid that may be collapsing the lungs. A chest tube may also be inserted into the lung(s) to reinflate a collapsed lung(s). The tube will drain into a bag hanging down under the bed. The tube itself doesn't hurt (once in place!), but it does hurt when they suction it out. It can be scary since it feels like someone has knocked the air out of you! The tube is usually held in place with a few stitches and leaves only a small scar when removed.

COMPUTERIZED TOMOGRAPHY SCAN (CT SCAN or "catscan")
It is a computerized test that takes pictures (of the brain, etc...)  utilizing X-rays. This thing looks like a big tunnel / doughnut and can be quite scary for children, if you don't tell them what to expect first. People who don't like confined spaces will not like it one bit. A scan is taken soon after the injury to help decide if surgery is needed and then the scan is repeated later to see how the brain is recovering. Dye is often injected during the procedure. This does not hurt, but does produce a sensation of heat all through your body for a few seconds.

CRANEOTOMY
The surgical removal of a portion of the skull to remove a blood clot or clots or in some instances, portions of the brain. The skull portion may be replaced immediately, a plastic or metal plate may be used or the patient's own skull portion frozen and replaced later.

ENCEPHALOGRAPHY
non-invasive use of ultrasound waves to record echoes from brain tissue. Used to detect hematoma, tumor or ventricle problems.

EKG/ECG (Electrocardiogram)
a diagnostic procedure that records the electrical activity of the heart. No pain here. Many sticky patches placed all over body in key points, with wires going from them to the machine.

ELECTROENCEPHALOGRAM (EEG)
An electrical test to determine brain activity; measures "electrical" current from nerve cells of the brain. This test helps diagnose specific neurological conditions, especially the presence of a seizure disorder.

ELECTROMYOGRAM (EMG)
a test that records the responses of muscles to electrical stimulation.

ENDOTRACHEAL TUBE
A tube that serves as an artificial airway inserted through the patient's mouth or nose and passes through the throat and into the windpipe (trachea). This is not to be confused with the NG (nasogastric) tube, which enters the nose or mouth and goes into the esophagus and stomach. The ENDO can be quite uncomfortable unless you are unconscious ...otherwise, it makes you feel like you are choking on something. They tend to leave you with a sore, scraped-feeling throat afterwards.

EVOKED POTENTIAL
registration of the electrical response of brain cells as detected by electrodes placed on the surface of the head at various places. The evoked potential, unlike the waves on an EEG, is elicited by a specific stimulus applied to the visual, auditory or other sensory receptors of the body. Evoked potentials are used to diagnose a wide variety of central nervous system disorders.

FES (Functional Electric Stimulation)
the application of low-level, computer controlled electric current to the neuromuscular system, including paralyzed muscle. FES is used to enhance or produce functions such as walking or bike exercises. FES has been used in experiments to facilitate grip in individuals with tetraplegia, using a switch activated by shoulder shrug. Other uses include correction of scoliosis, bladder control, electro-ejaculation, phrenic nerve stimulation. This electrical current isn't strong and doesn't hurt at all. Some people say they can't feel it...I just felt it as a tingling sensation. It shows promise for some individuals and conditions, although I didn't personally get much pain relief from it (mine was used for pain/muscle spasms in my back prior to spinal surgery).

FOLEY (FOLEY CATHETER)
A tube inserted into the bladder for the purpose of draining and measuring urine output. These are not usually "painful", but most definitely uncomfortable! The main problem with a catheter is the potential for infection. You will see the catheter leading to a collection bag hanging under the bed.

FROG BREATHING
see GLOSS PHARYNGEAL BREATHING (GPB)

GI TUBE (Gastrointestinal Tube)
A tube inserted through a surgical opening into the stomach. It is used to introduce liquids, food, or medication into the stomach when the patient is unable to take these substances by mouth. This tube doesn't seem to be painful and heals quickly when removed.

GLASGOW COMA SCALE (GCS)
a standardized system used to assess the degree of brain impairment and to identify the seriousness of injury in relation to outcome. The system involves three determinants: eye opening, verbal responses and motor response.  These three determinants are evaluated independently according to a numerical value.  The resultant value  indicates the level of consciousness and degree of dysfunction. Scores run from a high of 15 to a low of 3. Persons are considered to have experienced a 'mild brain' injury when their score is 13 to 15. A score of 9 to 12 is considered to reflect a 'moderate' brain injury and a score of 8 or less reflects a 'severe' brain injury. Compare to RANCHO LOS AMIGOS LEVELS OF COGNITIVE FUNCTIONING. There are differences.

GLOSS PHARYNGEAL BREATHING (GPB)
a means of forcing extra air into the lungs to expand the chest and achieve a functional cough. Also called "frog breathing."

HALO TRACTION
The process of immobilizing the upper body and cervical spine with a traction device. The device consists of a metal ring around the head, held in place with pins into the skull. A supporting frame is attached to the ring and to a body jacket or vest to provide immobilization. This hurts when they are placing the screws and pins in but after it heals, it's alright.

ICP / INTRACRANIAL PRESSURE MONITOR
Intracranial pressure monitor indicates pressure within the brain. It consists of a small tube attached to the patient at the skull and then to a monitoring device. The ICP monitor helps assure close observation of activity within the brain which may result in swelling of the brain. Some ICP monitors are small catheters or some are hollow, metal bolts screwed into the skill. You will see a patch ontop the head with a wire or small tube coming from it.

IV / INTRAVENOUS LINE
A catheter inserted into a vein through which fluids, antibiotics and other medication can be given directly. Just about everyone knows what an "IV" looks like or has had one themselves at some point. They do not hurt and the hand or arm in which the IV is inserted can be moved around fairly freely. If there is extensive damage to the hands/arms, an IV can also be placed into the top of one's foot. If you notice swelling or redness around the IV insertion site or red streaks leading up from the IV site, notify a nurse or doctor immediately. The actual tube can slip out of the vein it was in and the fluid from the IV will leak into the surrounding tissues causing swelling. The red streaks can mean infection or a localized reaction to medication being given through the IV.

IV BOARD
These are pieces of wood or plastic taped to the patient's arm or leg to keep the extremity immobile and thereby ensure the stability of the IV. These generally aren't used for simple IV's, but for arterial lines.

INTRAVENOUS PYELOGRAM (IVP)
an x-ray of the kidney to determine function.

KENDALLS (Kendall Stockings)
leg wraps that have air pockets constantly filling and releasing air (electronically timed), hence "massaging" the legs to prevent blood clotting, etc...

KUB
an x-ray of the abdomen, showing the kidneys, ureter, and bladder

LAMINECTOMY
an operation used to relieve pressure on the spinal cord, or used to examine the extent of damage to the cord.

LATERAL ANTERIOR DECOMPRESSION
surgical procedure to reduce pressure on the spinal cord by removing bone fragments.Some patients report dramatic functional improvement. It must be noted that medical success depends on patient selection since not all people qualify and not all benefit from this kind of surgery. Some conditions may worsen after surgery.

LEG BAG
external bag which is strapped to the leg for collection of urine.

MENTAL STATUS EXAMINATIONS
standardized tests which evaluate verbal responses and behavioral reactions; a procedure used to determine the mental competency of an individual.

MODIFIED BARIUM SWALLOW FUNCTION STUDY (DYSPHAGIAGRAM)
is a video fluoroscopic procedure that is used to  determine if a patient has a swallowing disorder and if aspiration (inhaling material into the lungs) is occuring with food and liquid items presented to  the patient. This procedure is done with a Radiologist. Recommendations are made based on the outcome of the study that might include changes in diet consistency or posture.

MONITOR
A television screen which shows his/her heart rate, respiration rate, ICP and/or other vital information. Most monitors have alarms which sound immediately when the information fed into the monitor deviates from within normal limits. Numbers will change rapidly and almost constantly. Don't be overly alarmed when this happens. It's often a WONDERFUL indicator when trying to determine if your loved one in a coma state knows you are there!  When they cannot respond in any other way at all, often times their heart rate, blood pressure, breath rate and ICP (pressure in brain) will increase dramatically whenever family members are present and trying to evoke a response from the patient. Doctors won't tell you this, but I know it's a fact.

MRI (Magnetic Resonance Imaging)
A high tech diagnostic tool to display tissues unseen in X-rays or by other techniques.  This is somewhat like a CT Scan in appearance, and tends to be VERY nosiy. It's a good test and can pick up on things that even a CT Scan cannot.

MYELOGRAM
A diagnostic test in which an opaque liquid is injected into the spinal canal, producing an outline of it on X-rays or fluoroscope. Now somewhat outdated by modern imaging diagnostics.  Some dyes are suspected of causing additional neurological problems.

NASOGASTRIC TUBE (NG TUBE)
A tube entering through the patient's  nose and ending in the stomach. The tube may be used to remove air and secretions as well as to feed the patient. Not painful, but most definitely uncomfortable.

NEUROPSYCHOLOGICAL ASSESSMENT
an evaluation of the patient's brain functions relating to behavior; based on the results of standardized tests, history, present circumstances, attitudes and the expectations of the patient was well as the patient's behavior during the examination.

NEUROPSYCHOLOGICAL EXAMINATION
the process of administering standardized tests designed to demonstrate brain dysfunction and its effects on behavior.

ORTHOSIS
Splint or brace designed to improve function or provide stability.

PERCUSSION
forceful tapping on congested parts of the chest to facilitate postural drainage in persons with people with high level tetraplegia.

POSTURAL DRAINAGE
using gravity to help the clear lungs of mucus by positioning the head lower than chest.

PRESSURE RELEASE
relieving pressure from the ischial turberosities (bones on which we sit) every 15 min. in order to prevent pressure sores.

PROSTHESIS
An artificail substitute for a missing body part, such a an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both.

RANCHO LOS AMIGOS LEVELS OF COGNITIVE FUNCTIONING (RLA)
Another system by which Drs. classify the level of head trauma and response. Similar to the GLASGOW COMA SCALE in what is being measured, the scales use a different system for numbering and should not be confused when speaking of a person's level of trauma / coma. The RLA designates eight levels of functions: No Response, Generalized Response, Localized Response, Confused-Agitated, Confused-Inappropriate, Confused-Appropriate, Automatic-Appropriate, and Purposeful-Appropriate.

RANGE OF MOTION (ROM)
the normal range of movement of any body joint. Range of Motion also refers to exercises designed to maintain this range
and prevent contractures.

RECIPROCATING GAIT ORTHOSIS (RGO)
a type of long leg brace used for ambulation by paralyzed people. Uses cables across the back to transfer energy from leg to leg, thereby simulating a more natural gait.

RESPIRATOR
see VENTILATOR

SHUNT
a tube used to drain a cavity. In the spinal cord, a shunt is used to treat a syrinx by equalizing pressures between the syrinx and the spinal fluids. In spinal bifida, it is used to reduce pressure of hydrocephalus. Is used to reduce pressure on the brain in TBI patients.

SPACE BOOTS, SPLINTS AND SHEEPSKINS
Some of the devices used  to maintain the normal posture of joints to prevent sores.

SPHINCTEROTOMY
the cutting of the bladder sphincter muscle to eliminate spasticity and related voiding problems. A non-surgical sphincterotomy uses a chemical block to inactivate transmitter-release between sphincter nerve and muscle, gradually stopping contractions; it is also reversible.

TENDON LENGTHENING
a procedure, usually involving the Achilles tendon, to treat contractures caused by spasms.

TENODESIS (Hand Splint)
metal or plastic support for hand, wrist and/or fingers. Used to facilitate greater function to a disabled hand by transferring wrist extension into grip and finger control.

TILT TABLE
a motorized table which is used to gradually increase patients tolerance to being in a standing position. Also used to teach partial weight bearing and to give prolonged stretch in each position.

TRACHEOTOMY
A surgical opening made in the patient's neck to allow the surgeon to insert a curved, plastic tracheal tube which will result in a direct route to the lungs. Called a "trach", for short. Patients will often have an "oxygen tube" connected to the trach hole... sometimes using forced oxygen to aid in breathing. Patients can "cough" through the trach site. The trach doesn't hurt, apparently. Once it is removed, they will place nothing more than a band-aid on the hole and it will heal easily and close in a few days. Once the trach is removed, the patient will be taught how to speak once again (barring any other physiological reason for not being able to speak).

TRACTION
A set of weights and pulleys to align fractured bones while they are in the process of healing. This contraption can be quite daunting when you first see your loved one lying there under it!

ULTRASOUND ECHO
Pictures made of internal body parts using sound waves in lieu of X-ray.

VENTILATOR
mechanical device to facilitate breathing in persons with impaired diaphragm function. Also known as a RESPIRATOR..

VITAL SIGNS
blood pressure, pulse, respiration and temperature