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Updated: May 3, 2026

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
Medical management of the comatose, vegetative, or minimally responsive patient
1Department of Rehabilitation Medicine, University of Pennsylvania Medical Center, 5 West Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Abstract:
This review outlines the range of medical problems occurring in brain injured patients in coma or emerging from coma, including the population of vegetative and minimally responsive patients. This range of medical problems includes those associated with the original brain injury or associated injuries, those representing complications of bedrest, and those caused by the use of medications that may retard recovery or contribute to an obtunded or comatose state. The review is organized by organ systems, each section including a brief discussion with reference to more indepth discussions in other sources. A number of algorithms are included to define approaches to evaluation of common clinical presentations which may be helpful to clinicians treating this population in acute or subacute settings.
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