Before You Call an ICU Patient COMBATIVE, See their Reality. A patient pulling at lines or resisting care can quickly get that label. Confusion or perceived threat may be driving it. Understanding what the patient is experiencing can change how you respond. 🧵

Understand the Behavior Before You Label It. What looks like resistance may be a response to fear or perceived threat. Understanding the patient’s reality can change how we approach them. Better care starts with asking what the patient thinks is happening.

Brain Death: What Turns the Exam Into a Diagnosis? A patient is deeply comatose with fixed pupils and absent brainstem reflexes. The examination points toward brain death. But what confirms that clinical picture?🧵

Brain Death is More than a Checklist The exam gives you the findings. The injury gives you the explanation. The tests add information within their limits. The diagnosis comes from putting the whole picture together.

Triple flexion can look purposeful. Hip flexion. Knee flexion. Dorsiflexion. But this movement can persist as a spinal reflex even in patients with no cerebral blood flow.