Andrew's story

Thomas's* story of recovery - Highbank's children's services

Thomas was 16 years old when he was admitted to Highbank’s children’s continuing care unit with a brain injury. He had attempted suicide, which resulted in a cardiac arrest, and cerebral anoxia (a complete interruption of the supply of oxygen to the brain). 

He was admitted from a district general hospital with:

• A percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) feeding tube
• A tracheostomy
• A need for a continence management programme
• The inability to verbalise and alert staff to any pain and discomfort
• Significant amounts of sedative medications

On admission, his presentation was complex and multifaceted. Initially managing his paroxysmal sympathetic hyperactivity (PSH) was key. PSH is an increased activity of the sympathetic nervous system, which manifests in recurrent episodes of tachycardia, hypertension, tachypnea, fever, diaphoresis, and dystonia. Therefore he required the support of an experienced brain injury interdisciplinary team (IDT) to undertake a comprehensive review and establish bespoke care plans, which Highbank could provide.

This addressed the potential triggers for his PSH, and the following were carefully managed and assessed:

• Pain
• Infection
• Respiratory distress
• Constipation
• Urinary retention
• Proper positioning

Following successful optimisation, the care review indicated there was an ongoing rehabilitation need and Highbank was able to offer this within its own robust pathway of care.

Thomas was transferred to Highbank’s adult, slow-stream neurorehabilitation unit, which allowed us to maximise his rehabilitation potential.