Using the Human Response to Illness Model to assess altered level of consciousness in patients with subdural hematomas.

Head injuries are the leading cause of trauma mortality and account for nearly half of all deaths related to trauma injuries. Patients who present with subdural hematomas are at risk for initial damage to the brain, as well as for subsequent brain damage related to re-bleed, ischemia or cerebral edema. These injuries can be acute or chronic in nature, and may be manifested in the patient as an altered level of consciousness. Skilled nursing assessment of altered level of consciousness leads to early nursing and medical intervention, which, in turn, can improve patient outcomes. In this paper, a critical review of the literature will focus on altered level of consciousness in patients presenting with a subdural hematoma. The Human Response to Illness Model will be utilized as a framework for this review. Accordingly, the physiological, pathophysiological, behavioural, and experiential perspectives of altered level of consciousness will be examined. Thus, a comprehensive understanding of this human response and rationale for evidence-based interventions will be established.