Awakening the Lethargic Patient

Stroke survivors in the acute care hospital may have difficulty waking up for each therapy session.

	Factors contributing to lethargy may include: acute medical conditions, medications or even the lack of sleep caused by multiple disruptions. Determine any necessary precautions, then try the following if your patient is difficult to arouse.
	Raise the height of the bed and get your patient in a more upright position to help increase their level of alertness. While raising the bed speak to your patient and call them by name.
	If there are no cardiac, sternal or other medical precautions, gently rub your patient’s sternum with a closed fist. This may be enough to help them wake up.
	If your patient continues to be lethargic, apply a cool washcloth to their face. Place a washcloth in your patient’s hand and guide the hand to the face. Your patient may begin to take over the movement, becoming more alert.

For more practical tips on managing the stroke survivor
in the acute care setting refer to,
Treatment Strategies in the Acute Care of Stroke Survivors.

I just returned from the AOTA national conference in Long Beach, California. It was wonderful to connect with so many therapists, faculty and students. Their message to me was clear: “Continue to provide us with videos and educational materials that are practical and relevant!”

Don’t forget to sign up for my Workshops:
   • St. Louis, MO (April 26-27)
   • Cincinnati, OH (May 31-June 1)
   • Detroit, MI (June 7-8)
Sign up while space is available.

Each StrokeHelp Newsletter will now include a section titled “Finding Evidence.” I will list helpful websites and resources for therapists to seek evidence to support their clinical practice.

The first three websites listed are specifically designed for OTs and PTs:

PEDro is a searchable database of randomized controlled trials, systematic reviews and evidence-based clinical practice guidelines.

OT Seeker is a searchable database of randomized controlled trials and systematic reviews relevant to occupational therapy.

OT CATS
A critically appraised topic (CAT) is a short summary of evidence on a topic of interest, usually focused around a clinical question. This website has a lot of information but is not peer-reviewed.

FreeMedicalJournals.com
I just found this website and am so excited to share it with you. It promotes free access to medical journals that offer articles online for free!

Please send me your feedback or suggestions. I'd love to hear from you.

International Clinical Educators, inc.