2.4 - TBI - Brain Injury Severity Measurement

Question 1

What are the 3 levels of assessment used in TBI patients?

Answer 1

Severity

Level of Cognitive-Behavioral Functioning

Cognitive-Communicative Functioning

Question 2

What can be use to assess Severity in TBI patients?

Answer 2

Glasgow Coma Scale

Question 3

What can be use to to assess Severity Level of Cognitive-Behavioral Functioning?

Answer 3

Ranchos Levels

Question 4

What 2 things do we assess Cognitive-Communicative Functioning?

Answer 4

Global functioning

Domains (e.g. memory, attention, etc)

Question 5

What 3 elements are assessed in the Glasgow Coma Scale?

Answer 5

Best Eye Response

Best Verbal Response

Best Motor Response

Question 6

What are the 4 types of Eye Response in the Glasgow Coma Scale?

Answer 6

No eye opening. (1)

Eye opening to pain. (2)

Eye opening to verbal command. (3)

Eyes open spontaneously. (4)

Question 7

What are the 5 types of Verbal Response in the Glasgow Coma Scale?

Answer 7

No verbal response (1)

Incomprehensible sounds. (2)

Inappropriate words. (3)

Confused (4)

Orientated (5)

Question 8

What are the 6 types of Best Motor Response in the Glasgow Coma Scale?

Answer 8

No motor response. (1)

Extension to pain. (2)

Flexion to pain. (3)

Withdrawal from pain. (4)

Localizing pain. (5)

Obeys Commands. (6)

Question 9

When does a client score a zero on the Glasgow Coma Scale?

Answer 9

It’s not possible. The lowest score is “3”

Question 10

Can patients have multiple Glasgow Coma Scale scores?

Why or why not? (2)

Answer 10

Yes.

One on the scene, one on the ER

They may change due to bleeding, swelling, etc

Question 11

What does the Glasgow Coma Scale rate?

2

Answer 11

The amount of acute disruption of brain physiology or structure

Severity of injury

Question 12

What scores indicate Severe Injury on the Glasgow Coma Scale?

Answer 12

3-8

Question 13

What scores indicate Moderate Injury on the Glasgow Coma Scale?

Answer 13

9-12

Question 14

What scores indicate Mild Injury on the Glasgow Coma Scale?

Answer 14

13-15

Question 15

A score on the Glasgow Coma Scale that is __________ means the patient is not in a coma.

Answer 15

≥9

Question 16

90% of patients that score _______ on the Glasgow Coma Scale are in a coma.

Answer 16

≤8

8 is the critical score

Question 17

___% of patents who score ≤8 on the GCS for ___ hours will die.

Answer 17

50%

6 hours

(8 is the critical score)

Question 18

How is consciousness affected in Mild TBI?

Answer 18

Brief loss of consciousness

Question 19

Can there be amnesia in Mild TBI?

2

Answer 19

Yes.

Brief post-traumatic amnesia

Question 20

What will a CT scan look like in Mild TBI?

Answer 20

Probably negative

Question 21

How common is MILD TBI?

Answer 21

Common but not serious

Question 22

What kinds of treatment is usually needed in cases of Mild TBI?

Answer 22

Most do not require any treatment

Question 23

What 4 things are normal in Mild TBI?

Answer 23

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)

Question 24

What is Post-Traumatic Amnesia (PTA)?

Answer 24

Any loss of memory following a TBI

Question 25

What is Retrograde Memory Loss?

Answer 25

Loss of memory/access to events occurring or information learned before an injury or onset of a disease.

Question 26

Is Retrograde Memory Loss a reliable prognostic predictor?

Answer 26

Yes

Question 27

What is Anterograde Memory Loss?

Answer 27

Loss of memory/access to events occurring immediately following the injury

Question 28

What level of Post-Traumatic Amnesia (PTA) is considered Very Mild?

Question 29

What level of Post-Traumatic Amnesia (PTA) is considered Mild?

Answer 29

5-60 minutes

Question 30

What level of Post-Traumatic Amnesia (PTA) is considered Moderate?

Answer 30

1-24 hours

Question 31

What level of Post-Traumatic Amnesia (PTA) is considered Severe?

Answer 31

1-7 days`

Question 32

What level of Post-Traumatic Amnesia (PTA) is considered Very Severe?

Answer 32

1-4 weeks

Question 33

What level of Post-Traumatic Amnesia (PTA) is considered Extremely Severe?

Answer 33

> 4 weeks

Question 34

What is the Galveston Orientation and Amnesia Test?

What does it correlate with?

Answer 34

A measure of Post-Traumatic Amnesia (PTA)?

Severity of brain injury

Question 35

How is the Galveston Orientation and Amnesia Test scored?

Answer 35

Begins with 100 pts.

Points are subtracted for each failed test

Question 36

What score on the Galveston Orientation and Amnesia Test is considered Average?

Answer 36

80-100

Question 37

What score on the Galveston Orientation and Amnesia Test is considered Borderline?

Answer 37

66-79

Question 38

What score on the Galveston Orientation and Amnesia Test is considered Impaired?

Answer 38

0-65