2.4 - TBI - Brain Injury Severity Measurement Flashcards
What are the 3 levels of assessment used in TBI patients?
Severity
Level of Cognitive-Behavioral Functioning
Cognitive-Communicative Functioning
What can be use to assess Severity in TBI patients?
Glasgow Coma Scale
What can be use to to assess Severity Level of Cognitive-Behavioral Functioning?
Ranchos Levels
What 2 things do we assess Cognitive-Communicative Functioning?
Global functioning
Domains (e.g. memory, attention, etc)
What 3 elements are assessed in the Glasgow Coma Scale?
Best Eye Response
Best Verbal Response
Best Motor Response
What are the 4 types of Eye Response in the Glasgow Coma Scale?
No eye opening. (1)
Eye opening to pain. (2)
Eye opening to verbal command. (3)
Eyes open spontaneously. (4)
What are the 5 types of Verbal Response in the Glasgow Coma Scale?
No verbal response (1)
Incomprehensible sounds. (2)
Inappropriate words. (3)
Confused (4)
Orientated (5)
What are the 6 types of Best Motor Response in the Glasgow Coma Scale?
No motor response. (1)
Extension to pain. (2)
Flexion to pain. (3)
Withdrawal from pain. (4)
Localizing pain. (5)
Obeys Commands. (6)
When does a client score a zero on the Glasgow Coma Scale?
It’s not possible. The lowest score is “3”
Can patients have multiple Glasgow Coma Scale scores?
Why or why not? (2)
Yes.
One on the scene, one on the ER
They may change due to bleeding, swelling, etc
What does the Glasgow Coma Scale rate?
2
The amount of acute disruption of brain physiology or structure
Severity of injury
What scores indicate Severe Injury on the Glasgow Coma Scale?
3-8
What scores indicate Moderate Injury on the Glasgow Coma Scale?
9-12
What scores indicate Mild Injury on the Glasgow Coma Scale?
13-15
A score on the Glasgow Coma Scale that is __________ means the patient is not in a coma.
≥9
90% of patients that score _______ on the Glasgow Coma Scale are in a coma.
≤8
8 is the critical score
___% of patents who score ≤8 on the GCS for ___ hours will die.
50%
6 hours
(8 is the critical score)
How is consciousness affected in Mild TBI?
Brief loss of consciousness
Can there be amnesia in Mild TBI?
2
Yes.
Brief post-traumatic amnesia
What will a CT scan look like in Mild TBI?
Probably negative
How common is MILD TBI?
Common but not serious
What kinds of treatment is usually needed in cases of Mild TBI?
Most do not require any treatment
What 4 things are normal in Mild TBI?
Any period of loss of consciousness,
Any loss of memory for events immediately before or after the
accident,
Any alteration in mental state at the time of the accident (feeling dazed, confused, or disoriented)
Focal neurological deficit which may or may not be transient (may not show
on imaging)
What is Post-Traumatic Amnesia (PTA)?
Any loss of memory following a TBI
What is Retrograde Memory Loss?
Loss of memory/access to events occurring or information learned before an injury or onset of a disease.
Is Retrograde Memory Loss a reliable prognostic predictor?
Yes
What is Anterograde Memory Loss?
Loss of memory/access to events occurring immediately following the injury
What level of Post-Traumatic Amnesia (PTA) is considered Very Mild?
What level of Post-Traumatic Amnesia (PTA) is considered Mild?
5-60 minutes
What level of Post-Traumatic Amnesia (PTA) is considered Moderate?
1-24 hours
What level of Post-Traumatic Amnesia (PTA) is considered Severe?
1-7 days`
What level of Post-Traumatic Amnesia (PTA) is considered Very Severe?
1-4 weeks
What level of Post-Traumatic Amnesia (PTA) is considered Extremely Severe?
> 4 weeks
What is the Galveston Orientation and Amnesia Test?
What does it correlate with?
A measure of Post-Traumatic Amnesia (PTA)?
Severity of brain injury
How is the Galveston Orientation and Amnesia Test scored?
Begins with 100 pts.
Points are subtracted for each failed test
What score on the Galveston Orientation and Amnesia Test is considered Average?
80-100
What score on the Galveston Orientation and Amnesia Test is considered Borderline?
66-79
What score on the Galveston Orientation and Amnesia Test is considered Impaired?
0-65
