Comatose Monitoring

OMT monitoring is appropriate for all coma patients, and is especially critical for those on a ventilator.

The brainstem is viewed by all neuroscientists as the main engine of the health status of the core brain, and yet today there is no method of directly monitoring its status in a general way.  Current standard of care revolves around the use of vital signs and multiple indirect tests, including the Glasgow Coma Score (CGS), the vestibulo-occular reflex (VOR), pupillary responsiveness, responses to painful stimuli, and systolic hypotension to name a few.  Glasgow Coma Scoring is the most relied upon, yet is not dynamic enough to reflect the moment-to-moment changes of the patient state.  Furthermore, it is not useful after drug induction.   

Each of these clinical measurements reflects the status of only one circuit within the brain – thus the need for numerous and diverse tests.  They are generally performed once every 30 to 60 minutes by the nursing staff and recorded on the patient record.  When reviewing the charts, the neuro-clinician must make decisions based upon his or her understanding of these indirect or secondary measurements and how they reflect what’s happening in the patient’s brain.  Further, these measurements were taken at a given point in time, and do not reflect a continuum of activity.  Neuro-clinicians need more reliable information for decision-making and improved care, as well as to be better able to communicate the patient’s status accurately and objectively to the family.

Studies have shown that OMT frequency, an objective measure of brainstem activity, is depressed in the comatose patient and that it correlates with patient state as currently measured by pupillary reflexes, Glasgow Coma Scoring, and brainstem auditory evoked responses (see Appendix B).  Studies have also shown that certain OMT frequency levels can anticipate favorable or unfavorable outcomes, which would allow for improved allocation of resources to patients with a greater chance of recovery (Appendices B and C).

Through continuous OMT monitoring, caregivers can be alerted to changes in the patient’s condition, allowing for more timely and effective adjustments to treatment strategies.  And they can readily determine through changes in OMT whether or not their treatment choices are having the desired results.  Because of this, we believe that significant improvement in clinical pathways will be provided by the introduction of real-time OMT monitoring, resulting in shortened stays, saving of lives, and huge economic productivity gains estimated to be up to $6 billion for this market, or 15% of current expenditures.