Definitions of Words Used in Hospitals

Not normal
Acute Care
Care provided during the very early stages following an injury, including surgery and intensive care. Focus of care is on the child becoming medically stable.
Acute Rehabilitation Program
Primary emphasis is on the early phase of rehabilitation which usually begins as soon as the child is medically stable. The program is designed to be comprehensive and based in a medical facility with a typical length of stay of 4 - 6 weeks.
Advocacy Organization
A group of individuals who can listen to your problems and ideas and help you find solutions or make decisions. They can guide you through an application process, request special services or treatment, obtain financing for equipment, or resolve disagreements on school issues.
Alert (Awake)
State of being watchful or ready.
Difficulty remembering events occurring during a particular period of time. Loss may be permanent or temporary.
A physician who administers anesthesia (pain killers) during surgery.
A lack of oxygen. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.
Type of drug given to help prevent stomach ulcers. Common medications to accomplish this are Zantac, Omeprazole
Type of drug given to fight infection. Most antibiotics are given through an intravenous catheter (IV), whereas others may be placed on the skin or into the nasogastric tube. Occasionally antibiotics must be given through a ventriculostomy catheter directly into the ventricles of the brain.
Type of drug given to prevent blood clots from forming. Sometimes this type of drug is called a "blood thinner". Common medications used to accomplish this are Coumadin and Heparin.
Medications used to decrease the possibility of a seizure. Medications include Dilantin, Phenobarbital, Tegretol, Mysoline, and Phosphenytoin.
Arm Board
A piece of wood or plastic taped to the child's arm to prevent IV catheters in the arm from being bumped and dislodged.
Arterial Line
A very thin tube (catheter) inserted into an artery to allow direct measurement of the blood pressure, the amounts of oxygen and carbon dioxide in the blood.
A blood vessel carrying bright red blood because it is rich in oxygen.
When fluid or food accidentally enters the lungs through the windpipe. This can cause a lung infection or pneumonia.
Attending Physician
The doctor ultimately responsible for the care of a child who has been hospitalized.
The main or core nerve fiber which generally conducts impulses away from the cell body.
Both right and left sides of the body.
Brain Injury
Any damage to the brain that results in impairments in cognitive, speech/language, and behavioral functioning. It also may involve impairments to physical functioning like movement and balance. Damage may be caused by an external force, insufficient blood supply, toxic substances, cancer and tumors, infections, birth related disorders, or degenerative processes. A traumatic brain injury is limited to injuries caused by an external mechanical force or motion.
Brain Injury, Acquired
The implication of this term is that the individual experienced normal growth and development from conception through birth, until sustaining an insult to the brain at some later time which resulted in impairment of brain function.
Brain Injury, Traumatic
Damage to living brain tissue caused by external mechanical force or motion. It is usually characterized by periods of altered consciousness (amnesia or coma) that can be very brief (minutes) or very long (months/indefinitely). The term does not include brain injuries that are caused by insufficient blood supply, toxic substances, cancer, infections, congenital disorders, birth trauma, or degenerative processes.
Closed Brain Injury:
A traumatic brain injury occurring when the head accelerates and then rapidly decelerates or collides with another object (for example, the windshield of a car). Brain tissue is damaged, not by the presence of a foreign object within the brain, but by violent smashing, stretching, and twisting, of brain tissue. Closed brain injuries typically cause diffuse tissue damage that results in disabilities which are generalized and highly variable.
Penetrating Brain Injury:
A traumatic brain injury occurring when an object (for example, a bullet or knife) fractures the skull, enters the brain, and tears the soft brain tissue in its path. Penetrating injuries tend to damage relatively localized areas of the brain which result in fairly discrete and predictable disabilities.
Brain Stem
The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brain stem include those necessary for survival (breathing, heart rate) and for arousal (being awake and alert).
Case or Care Manager
The case manager helps the child find appropriate medical, rehabilitation, and support programs. The case manager also assists in the coordination and delivery of these services, while keeping track of insurance benefits and cost of care. This professional may coordinate with various professionals and agencies, advocate on behalf of the family and child, and arrange the purchase of services where no appropriate programs are available.
A flexible tube which may be placed in several parts of the body to administer medications or nutrients, drain body fluids, or take samples and measurements. Frequently, a catheter is called a "line".
Central Venous Pressure Line
A catheter inserted first into a vein and then pushed into the large vein near the heart in order to measure the blood pressure there.
The portion of the brain (located at the back) which helps coordinate movement. Damage may cause a problem with muscle coordination which can interfere with a child's ability to walk, talk, eat, and to perform self care tasks.
Cerebral Angiography
A medical test involving injection of dye into an artery so that the vascular system of the brain can be studied using an x-ray.
Cerebral Compression
The brain is pushed and compressed by the presence of a tumor, aneurysm, swelling, or hematoma (blood clot).
Cerebral Edema
Brain swelling caused by brain injury which, if not controlled, may cause death by producing excessive intracranial pressure.
Cerebral Hemorrhage
Bleeding of a blood vessel within the brain.
Cerebral-Spinal Fluid (CSF)
Clear liquid which normally fills the ventricles of the brain and surrounds the brain and spinal cord.
Chest Tubes
Tubes inserted into the child's chest to allow fluid and air to drain from the area surrounding the lungs. Removing this fluid and air from around the lungs allows the child to breath better.
Child Life Specialist
A professional with special training in helping children cope with hospitalization and medical procedures and equipment used to treat their illness or injury.
A long-term disease or condition.
Chronic Care
Long-term care for those children who require medical care.
Closed Head Injury
See Brain Injury, Closed Brain Injury.
Congenital Disability
A disability that has existed since birth but is not necessarily hereditary.
The conscious process of knowing or being aware of thoughts or perceptions, including understanding and reasoning.
Cognitive Impairment
Difficulty with one or more of the basic functions of the brain: perception, memory, attentional abilities, and reasoning skills.
Cognitive Rehabilitation
Therapy programs that help with perception, memory, thinking, and problem solving. Skills are practiced and methods are taught to help improve function and/or compensate for cognitive limitations.
A state of unconsciousness from which the child cannot be awakened or aroused, even by powerful stimulation. A comatose child cannot follow a one-step command such as "Hold up one finger" or "Stick out your tongue". However, the comatose child may move or groan in response to touch or pain, or even move on his own. A person in a coma will have a Glasgow Coma Scale score of 8 or less.
Computerized Axial Tomography (CAT Scan)
An x-ray technique using a computer which takes photographs that look like "slices" of the body's internal tissues. Often, a CAT scan is taken soon after the injury to help determine if surgery is needed. The scan may be repeated later to see how the brain is recovering.
The common result of a blow to the head or sudden deceleration, usually causing an altered mental state, which can be temporary or prolonged. Physiologic and/or anatomic disruption of connections between some nerve cells in the brain may occur. This term is often used by the general public to refer to a brief loss of consciousness.
The state of awareness of the self and the environment.
Consulting Physician
Doctors who have been asked to give their advice on the child's plan of care.
The ability to control urination and bowel movements.
Contra Coup
Bruising of brain tissue on the side opposite from where the blow was struck.
Contusion, Brain
A bruise. The result of a blow to the head which bruises the brain.
The name of the disease or condition a child has or is believed to have. The value of establishing a diagnosis is to provide a logical basis for treatment.
Diffuse Axonal Injury (DAI)
Widespread damage to large nerve fibers located in the brain. Injury is caused by rotational shearing forces occurring with head trauma.
Diffuse Brain Injury
Injury to cells in many areas of the brain rather than in one specific area.
An anti-seizure drug that may be given to prevent seizures.
Not knowing where you are, who you are, or the current date. Health professionals often speak of a normal person as being oriented "times three" which refers to person, place, and time.
A drug used to increase blood pressure.
Swelling caused by a buildup of fluid in the body's tissues.
Electrocardiogram (ECG)
An electrical test of the heart done by placing electrodes on the chest. Most brain injured children in the ICU have their hearts monitored continuously.
Electroencephalogram (EEG)
An electrical test of the brain done by placing electrodes on the scalp. The EEG is very good at detecting seizures.
Emergency Medical Service (EMS)
General term used for ambulance or rescue squad.
Endotracheal Tube
A tube that serves as an artificial airway and is inserted through the child's mouth or nose. It passes through the throat and into the air passages to help breathing. Because it passes through the vocal cords, the child will be unable to speak as long as the endotracheal tube is in place. It is the tube that connects the child to the respirator.
Evoked Response (Potential) Test
Electrodes placed on the surface of the head to register the electrical responses of active brain cells. The evoked potential is obtained by a stimulus applied to the visual, auditory, or other sensory receptors of the body. A machine is used to test whether the brain has received the signals.
External Fixation Device
A special splint to hold broken bones in place. Such devices are connected to pins that are placed through the bones.
External Ventricular Drain
A thin tube (catheter) placed through the skull into one of the cavities (ventricles) in the brain. The catheter may be used to measure pressure, withdraw fluid, or in some cases, to administer medicines.
Eye Tape
Brain injured children in the ICU may have their eyes taped shut to prevent them drying out or being scratched. Sometimes salve or "artificial tears" are used instead of tape.
Restricted to one region (as opposed to diffuse).
Foley Catheter
A tube inserted into the bladder for the drainage of urine. The urine drains into a plastic bag hanging by the side of the bed.
Frontal Lobe
Front part of the brain behind the forehead. The frontal lobe is involved in planning, organizing, problem solving, using good judgment and reasoning, inhibiting or initiating responses and reactions, and focusing attention. The frontal lobe governs much of what we do and helps us make decisions about our actions.
Glasgow Coma Scale (GCS)
A rating scale used to assess the level of consciousness following brain damage. The scale assesses eye, verbal, and motor responses. Scores range from a high of 15 to a low of 3. Lower scores indicate greater neurological impairment. Children 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.
A thin metal ring fastened around the head of a child with a spinal injury. The ring prevents the child's head and neck from moving.
The collection of blood in tissues or a space following rupture of a blood vessel. Blood may pool in four areas of the brain: 1) the epidural area which is located outside the brain and its fibrous covering, but under the skull; 2) the subdural area which is between the brain and its fibrous covering (dura); 3) the intracerebral area which is inside the brain tissue; and 4) the subarachnoid area which is around the surfaces of the brain, between the dura and arachnoid membranes.
Bleeding that occurs when blood vessels are damaged.
A physician who works only in the hospital setting. Their specialty is acute, hospital level care. This person is available 24 hours a day to offer care to the patient and reports back to the attending physician.
Low level of oxygen in blood.
Inability to control bowel and bladder functions.
Intensive Care Unit (ICU)
The place in the hospital where critically ill patients are cared for.
Between the cerebral hemispheres.
A physician who has completed his medical training and is usually in his or her first year of specialty training. Interns work under supervision of Residents and the Attending Physician.
A physician with expertise in internal medicine. Internists are often consulting physicians for brain injured persons because they are experts in infectious diseases and diseases of the heart, gastrointestinal tract, and other internal organs.
Intracranial Insult
Something that causes injury to the brain. Includes hematomas, increases of intracranial pressure (ICP), brain swelling, edema, and vasospasm.
Intracranial Pressure (ICP)
Brain swelling or edema causes pressure to build up inside the bony skull. This pressure is called intracranial pressure.
Intracranial Pressure Monitor (ICP Monitor)
A tube inserted through the skull into either a space between the brain and the skull or into one of the cavities (ventricles) in the brain. The pressure in the brain is measured by an instrument (transducer) connected to the other end of the line. Some ICP monitors are small catheters and others are hollow metal bolts screwed into the skull.
Intravenous Line (IV)
A thin tube (catheter) inserted into a vein through which fluids and medications are given. Sometimes a needle can be seen at the end of the catheter.
Lasix (Furosemide)
This drug assists the body in eliminating water. It may be used to treat intracranial pressure, too much water in the lungs, or sluggish kidneys.
A defined part of the brain separated by boundaries from other parts of the brain. The lobes of the brain are called the frontal, parietal, temporal , and occipital,.
A medicine given usually by nasogastric (NG) tube to help prevent stomach ulcers.
Magnetic Resonance Imaging (MRI)
The MRI is a special type of x-ray which uses a computer to produce a two dimensional picture of internal organs. An MRI uses magnetic fields and sound waves to produce the picture.
A medicine used to remove water from the brain and thereby lower intracranial pressure (ICP). The mannitol and water are then eliminated by the kidneys.
Monitor, Cardiac-Respiratory
A television screen near the child's bed which shows his or her heartbeat, blood pressure, and other important information. Most monitors have alarms to alert the staff that something may be wrong. Interpreting the information shown on the monitor requires considerable training and experience.
Morphine (MS)
A strong sedative which is also an excellent pain reliever.
Drugs used to treat pain. Morphine, Fentanyl
Nasogastric Tube (NG Tube)
A tube going from the nose into the child's stomach. Initially, this tube is used only to remove air and secretions from the stomach. Later, it may be used for feeding as well.
A physician who specializes in diseases of the brain, nerves, and muscles.
A psychologist with special skills in dealing with people with brain injury. Neuropsychologists administer special tests of brain function and coordinate the rehabilitation of brain injured children.
A surgeon who is an expert in diseases and conditions of the nervous system. A neurosurgeon is often the attending physician supervising the care of children and adults with brain injury.
Non-purposeful Movement
When a person moves for no purpose or reason.
A professional providing direct patient care and continuous monitoring of the patient's condition. Nurses are an important link between the patient and the physician. Nurses in the ICU have extra training and experience in treating seriously injured or ill children and adults.
An expert in the feeding and nutritional needs of people.
Occipital Lobe
The occipital lobe is located in the rear of the brain and is responsible primarily for vision. Damage to the occipital lobe can cause problems with sight.
Occupational Therapist (OT)
An expert in helping people achieve independence in the activities done on a daily basis. Occupational therapists work on improving thinking skills through interaction and activities with brain injured people.
Orthopedic Surgeon
A physician who specializes in diseases of bones. Orthopedic surgeons are often involved in the treatment of injuries to the limbs and backs of children and adults who also have brain injuries.
Loss of sensation (feeling) and voluntary muscle movement. It may be temporary or permanent.
Parietal Lobe
There are two parietal lobes (right and left) of the brain. They are located at the top and back of the brain, behind the frontal lobes. The parietal lobes are involved in touch perception and sensation. Children with damage to this area may not be able to perceive when they are being touched or when they are touching someone or something. A child with damage to the right lobe may have difficulty finding his way around new--or even familiar--places. Damage to the left lobe may cause problems with the child's ability to understand spoken or written language.
Drug which temporarily paralyzes all the muscles in a patient's body. This medicine may be used to prevent the patient from resisting the ventilator.
Pavulon (Pancuronium Bromide)
A drug that temporarily paralyzes all the muscles in a patient's body. This medicine may be used to prevent the patient from resisting the ventilator.
Pediatric Intensivist
A physician who is an expert in caring for children who need intensive care and close monitoring. The pediatric intensivist may be the attending physician supervising the care of a child with a brain injury.
Pediatric Trauma Surgeon
A surgeon who is an expert in childhood diseases and injuries. He operates only on children. The pediatric trauma surgeon may be the attending physician supervising the care of a brain injured child.
A physician who is an expert in the treatment of children's diseases.
Pentobarbital (Nembutal)
A strong sedative used to control intracranial pressure (ICP). Pentobarbital acts as an anesthetic which places the brain injured child in a deeper coma.
A drug used to prevent seizures. Phenobarbital may occasionally be used like pentobarbital to control intracranial pressure (ICP).
A physician who is an expert in physical retraining and other aspects of rehabilitation. The rehabilitation team is sometimes headed by a physiatrist.
Physical Therapist (PT)
An expert in maintaining and improving the movement of joints and limbs. Physical therapists perform specialized techniques to maintain normal muscle tone. They begin a program of active physical reconditioning when recovery has progressed far enough.
Post-Traumatic Amnesia
When children with brain injury are awake but unable to remember or recall what happened just a few hours or even minutes ago. The child can be disoriented or confused about the day and time, about where they are, and sometimes about who they are. Sometimes they are very restless and cannot be comforted.
Drug used to increase blood pressure. Dopamine, Epinephrine
Primary Care Nurse
The nurse primarily responsible for the nursing care of a particular child.
The outlook for recovery from a disease or injury as indicated by the nature and symptoms of the case.
A physician who is an expert in the management of behavioral problems and emotional conditions. Psychiatrists are able to prescribe medications.
A non-physician who is an expert in the management of behavioral problems.
A physician who specializes in problems with the lungs.
Pulse Oximeter
A painless sensor attached to the child's body (usually to a finger or toe) which measures the amount of oxygen in the blood.
Rancho Los Amigos Scale
This scale is used to describe behavior and abilities of a child or adult who is gradually coming out of a coma. There are 8 levels of response, and each level describes the child's awareness and response to the environment and interactions with people.
The process of directing a patient to an agency, professional, or other resource for services.
The process of helping a child or adult to achieve his or her maximum functional potential. The process of rehabilitation should begin immediately. Some aspects of rehabilitation can begin even while the child with a brain injury is in a coma. Problems that rehabilitation will work on include: movement, ability to care for one's self, memory, attention, slowness of thinking, difficulty with complex thinking, difficulties with speech and language, changes in behavior, and personality changes.
A physician who has finished medical training and is taking additional training in a specialty such as neurosurgery. Residents are supervised by the Attending Physician who is responsible for the care of the child.
A machine that moves air in and out of the child's lungs. Sometimes the child can trigger the ventilator by starting to take a breath. At other times the ventilator works without being triggered. When precise control of breathing is important, it may be necessary to sedate or temporarily paralyze the patient so that he does not "fight" the ventilator.
Respiratory Therapist (RT)
A person with special skills in operating machines to aid breathing and in keeping the brain injured child's airway open.
Retrograde Amnesia
Inability to recall the accident that caused the injury or the events immediately preceding the accident.
Sedation and Sedatives
A state of being calmed. Drugs called sedatives are used to create this state. Common medications used to accomplish this are Versed and Ativan.
Seizures are caused by abnormal brain activity and are common in children with severe brain injury. Some seizures cause unusual twitching or shaking of the body. Other symptoms of seizures include vacant or blank staring and lack of response to voice or touch.
Skull Fracture
The breaking of the bones surrounding the brain. A depressed skull fracture is one in which the broken bone pushes inward.
Social Worker
An expert in the social aspects of brain injury treatment and rehabilitation. Social workers do a wide range of work from finding sources of funds to providing emotional support for families.
Muscle spasm caused by nerve injury. Spastic muscles usually have very quick reflexes and sometimes will quiver on their own.
Speech/Language Pathologists
An expert in caring for problems with expressing and understanding language. Language and swallowing problems are among the most common and long-lasting problems in brain injured children.
Subarachnoid Screw
Also called a Subarachnoid Bolt. A device that measures intracranial pressure. It is screwed through a hole in the skull and rests on the surface of the brain.
Support Group
A group established for families and/or persons with disabilities to discuss the problems they may be having in coping with their life situations and to seek solutions to these problems.
Swan-Ganz Catheter
A special catheter inserted into a small vein and pushed inside the vein into the heart. This catheter may be used to measure pressures in different parts of the heart and to measure how hard the heart is working.
Temporal Lobes
There are two temporal lobes, one on each side of the brain, located at about the level of the ears. The temporal lobe is associated with the concept of time and is also involved with emotion, short-term memory, and hearing. These lobes allow a person to tell one smell from another and one sound from another. The right lobe is mainly involved in visual memory (pictures and faces), and the left lobe is mainly involved in verbal memory (words and names).
A hole made in the child's neck into the airway, which allows him to breathe with a ventilator. Tracheostomy controls breathing in patients who require long-term breathing assistance. The tracheostomy closes up by itself after the tube is no longer needed.
An arrangement of weights and pulleys to keep fractured bones straight while they are healing.
An instrument used to measure blood pressure, intracranial pressure, and other important information. Transducers are usually connected to a monitor.
A method of making a picture of internal body parts using sound waves instead of x-rays.
Unit Clerk or Secretary
A person who coordinates messages and keeps records in the nursing unit or floor for each patient.
Valium (Diazepam)
A drug used to stop seizures.
Ventricles, Brain
Four natural cavities in the brain that are filled with cerebrospinal fluid. The outline of one or more of these cavities may change when a space-occupying hemorrhage or tumor has developed in a lobe of the brain.