Faculty
•Craig C. DiTommaso, MD, FAAPMR
•Alan H. Weintraub, MD, FAAPMR
•Brooke Murtaugh, OTD, OTR/L, CBIST
•Amy Rosenbaum, PhD, FACRM
•Katherine O’Brien, PhD

Description
Disorders of Consciousness are complex states that may affect survivors of severe brain injury. Historically, a disorder of consciousness was thought to be indicative of a poor prognosis and precluded patients from further rehabilitation efforts. However, recent long-term outcome studies demonstrate those with traumatic DOC can achieve better functional outcomes and quality of life than previously thought. That is why it is imperative for physiatrist to understand the potential of patients in DOC. Furthermore, physiatrist equipped with the appropriate knowledge and understanding of appropriate interventions can facilitate a positive trajectory of recovery. This course will provide an overview of recently published DOC Practice Guidelines with key clinical insights into applications. Our multi-disciplinary team will address guideline-related domains of assessment, diagnosis, medical management, prognosis, and confounders to further clinical treatment for this disorder. Appropriate medical management, rehabilitation interventions, and expectations for recovery will be illustrated with clinical examples. Case studies will be utilized to demonstrate application of the guidelines and to stimulate discussions regarding best practice concepts. Physiatrists will see how clinicians in the field use real-world cases to develop a road map to recovery for the severe brain injury survivors experiencing DOC. Virtual problem-solving case studies will be provided for all attendees.

Course Objectives:
At the conclusion of this activity, attendees will be able to:
•Describe an overview of the DOC Practice Guidelines (Giacino et al. 2018).
•Describe assessment tools and strategies for accurate diagnosis of DOC.
•Identify interdisciplinary approaches to assessment and treatment of DOC.
•Define behavioral and medical confounders impacting the presentation with DOC.
•Identify common medical complications in the DOC population and describe associated signs and symptoms.
•Develop rehabilitation concepts for promoting early mobility, communication, and cognition.
•Describe long term outcomes and prognosis of prolonged DOC.
•Participate in discussion, problem solving, and plan of care development related to DOC case studies through application of appropriate assessment and intervention strategies.

Agenda
•Introduction to Day and Overview of DOC Practice Guidelines
•Quantifiable Assessments, Behavioral Interventions Related to Assessment, Diagnosis
•Medical Management, Confounding Diagnostic and Management Considerations
•Prognostication, Outcomes, and Clinical Pearls
•Interdisciplinary Approach to DOC Assessment and Care Planning
•Caregiver/Family Training: DOC Recommendations & Timing it Right
•Group Case Studies and Group Discussion