Introducing

The Prolonged Disorders of Consciousness Unit at The Wellington Hospital

The Prolonged Disorders of Consciousness Unit is a specialist service which provides the next natural step on the patient’s journey to consciousness and works closely with our award-winning intensive care unit.

Patients are offered a continuous service at the new state-of-the-art PDoC Unit based in The Wellington Hospital South Building.

The PDoC team is a group of specialists working across intensive care and other acute departments, focusing on the issues facing patients emerging from disorders of consciousness and ensuring continuity of care.

Following national standards and guidelines, the team work together to provide specialist care.

A pathway to consciousness

The specialist service provided by the Prolonged Disorders of Consciousness (PDoC) Unit is the only one of its kind

in the UK private healthcare sector.

What is a Prolonged disorder of consciousness?

This is when a person is no longer in a coma but remains in a state of altered consciousness for more than four weeks after an injury. It is essential for the patient to receive specialist support through this process to give each patient every chance of optimising their recovery.

Causes of PDoC:

Common causes of brain injury resulting in prolonged disorders of consciousness:

• Head injury

• Stroke

• Reduced oxygen to the brain

• Infection

• Poisoning (drug/alchohol)

Different Levels of Consciousness

Following severe brain injury, many patients progress through the different levels of consciousness when emerging from a coma

• Coma (Absent wakefulness and absent awareness)

• Unresponsive Wakefulness Syndrome or Vegetative State (Wakefulness with absent awareness)

• Minimally Conscious State (Wakefulness with minimal awareness)

Some patients will not emerge from a vegetative or minimally conscious state.

Patient Pathway The key overlapping phases for patients with Prolonged Disorders of Consciousness (PDoC)

The emotional and educational needs of both the

patient and their family are of a

primary concern to the team

The only unit of its kind in the UK private sector

Linking clinical research,

practice and excellence

Acute Assessment Unit (AAU)

IntensiveCare Unit

(ICU)

ProlongedDisorders of

ConsciousnessUnit (PDoC)

Discharge Follow up

The PDoC Unit ProvidesThe team uses unit specific, interdisciplinary, integrated PDoC pathways, which are based on recently published National Guidelines (Royal College of Physicians, 2013), ensuring a structured approach to delivery of care to our patients. Our skilled inter-disciplinary PDoC team links with ICU, providing a seamless service, which places the patient on a continuum (an integrated pathway of care) using specialist evidence based practice.

• Assessment, diagnosis and monitoring • Structured care pathway – acute to longer

term management • Management of ethical and medico-legal issues • Best interest decision making • Ensure best practice in the management and

treatment of patients in a prolonged disorder of consciousness

• Family support and education. The unit team ensures that the family is involved in all aspects of care and treatment, as appropriate

• Evidence based intervention programmes • Inter-disciplinary planning and goal setting • Specialist service

• Stimulation programmes

The unit has been established to blend clinical practice with research exploration to guide patient care. Forging links with International Prolonged Disorders of Consciousness (PDoC) research facilities, the unit seeks to explore assessment and treatment techniques; in particular, the clinical use of functional magnetic resonance imaging (fMRI), near infrared spectroscopy (NIRS)andelectroencephalogram(EEG)forthebenefitofour patients and to keep us at the forefront of advances in research.

ERIGO®Pro – Functional Electrical Stimulation (FES)

We have invested a lot of research into our robotic assistive technology. Our primary state-of-the-art piece of equipment is the ERIGO®Pro; a tilt table with integrated leg drivers. Under the instruction of our trained team of specialists the ERIGO®Pro can be used to achieve an early upright position. The use of the leg drivers reduces incidents of complication related to low blood pressure in early assessment of acute neurological patients in prolonged disorders of consciousness.

Using the more advanced version with electrical stimulation provides us with the opportunity to further enhance muscular activity and sensory input. When used in early assessment of patients with altered consciousness, blood pressure regulation can be further improved. Providing increased sensory stimulation as one method of increasing levels of arousal, provides an opportunity to assess, in greater detail, an individual’s potential to respond.

This technology forms part of the detailed and specialist interdisciplinary assessment and intervention we provide on the unit.

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keep layout consistent

Travelling to The Wellington HospitalLondon Underground St John’s Wood, Baker Street and Marylebone Overground Train West Hampstead Thamesline (interchange with Jubilee line) and Marylebone Bus Routes 13, 113 from Oxford Street and 82 from Victoria, which all stop on Park Road and Wellington Road Coach Green Line coach services from Hertfordshire, Bedfordshire and Luton Car Parking Limited pay and display parking is available in surrounding streets. There is also a Masterpark car park on Kingsmill Terrace and an NCP car park on Park Road

The Team Approach Our skilled team ensures a consistent co-ordinated approach to recovery and includes:

• Consultant

• Dietitian

• International Language Interpreter

• Neuropsychologist

• Occupational Therapist

• PDoC Admissions Coordinator

• PDoC Nurse

• Pharmacist

• Physiotherapist

• ResidentMedicalOfficer

• Speech and Language Therapist

Visiting Hours Morning 10.00 – 14.00Afternoon 16.00 – 20.00

Visiting can be allowed outside these hours at the discretion of the charge nurse.

Contact Details Prolonged Disorders of Consciousness (PDoC) UnitTel: 020 7483 5591 Fax: 020 7483 5588Email: wellington.enquiryhelpline@hcahealthcare.co.uk

Where to find usThe PDoC Unit The Wellington Hospital 5th Floor, South BuidlingWellington PlaceSt John’s WoodLondonNW8 9LE