Early intervention: coma stimulation in the intensive care unit.

Coma stimulation is a technique that has traditionally been reserved for patients in a rehabilitation setting. Information regarding the use of coma stimulation in the intensive care setting is limited. An individualized coma stimulation program in the early stages of recovery from brain injury is paramount in stimulating the reticular activating system and promoting brain reorganization. Coma stimulation program development within the intensive care setting includes the appropriate selection of patients and the utilization of the entire rehabilitation team in devising an approach specific to each patient's needs. Planning should include the family, with consideration to the prior interests of the patient. Ongoing evaluation of the patient's responses should be considered, as well as the ease of performing stimulation within the intensive care environment.