ABSTRACT
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611 Appendix 1 - Sample Life Care Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 612
The challenge for patients with carbon monoxide (CO) poisoning is similar to patients with other serious medical problems, to successfully reintegrate at home and work. The process to achieve that goal begins with a rehabilitation evaluation of the impact of CO poisoning on the patient’s cognitive, emotional, and physical functioning in the community. The rehabilitation evaluation is a systematic, comprehensive assessment process, often using a team approach, which is highly individualized. The goal is to assess residual work potential and skills by means of a variety of tools, including possible testing (or reviewing neuropsychological test data) or other means which are individualized for the patient. The rehabilitation evaluation of a CO-poisoned patient requires specialized knowledge of neuropsychological assessment tools, and in virtually all cases the rehabilitation counselor should consult directly with the neuropsychologist and physician early in the process and prior to initiating any return-to-work plan. The reality of rehabilitation counseling practice today is that counselors have probably had little exposure to assisting CO patients with returnto-work issues and may not be familiar with the myriad of symptoms which are being experienced. Thus, it is critical that counselors begin to share information and knowledge on the subject. Regardless of counselor sophistication on CO, the better rehabilitation plans are ones that represent a consensus of opinion among key professionals and the patient/family members. By working toward a consensus, the rehabilitation counselor improves the probability that the individualized return-towork plan is the right one for the CO poisoned patient. The four steps in the evaluation process include information gathering, analysis, synthesis, and interpretation.1,2 Of critical importance is a comprehensive review of available medical records regarding the CO poisoning and subsequent treatment. The variables to be considered by the rehabilitation counselor in that assessment are extensive, but most are known or can be determined with quality interview and assessment tools. There is no cadre of experienced rehabilitation counselors throughout the United States who specialize in rehabilitative evaluation and treatment for persons with CO poisoning. Virtually all
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in working with persons with brain injuries, but the constellation of chronic symptoms which often accompanies CO poisoning presents unique challenges for community reintegration.
