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NCS > Concussion/TBI > Flashcards

Concussion/TBI Flashcards

1
Q

Canadian CT Head Rule
Definition of Minor Head Injury

A

Minor head injury is defined as witnessed loss of consciousness, definite amnesia, or witness disorientation in patients with a GSC 13-15

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2
Q

Canadian CT Head Rule
High Risk - for Neurological intervention

A

1 of the follow:
1) Suspected open or depressed skull fracture
2) Vomiting more than 2 episodes
3) GCS of less than 15 at 2 hours
4) Signs of basilar skull fx (raccoon eyes, CSF leakage)
5) Age 65 or older

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3
Q

Canadian CT Head Rule
Medium Risk for brain injury on CT

A

1 of the following:
1) Amensia greater than 30 minutes prior to injury
2) Severe mechanism: hit by a MVA, fall from greater than 3 feet, ejected from a MVA

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4
Q

PECARN
CT recommendation for younger than 2 years old

A

1) GCS less than 15 OR
2) AMS OR
3) Palpable Skull fx

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5
Q

PECARN
CT recommendation for 2 years old or older

A

1)GCS less than 15 OR
2) AMS OR
3) Basilar skull fx

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6
Q

PECRAN
Observation vs CT head for younger than 2 years old

A

1) Not acting normal
2) LOC greater than 5 seconds
3) Non-frontal Hematoma
4) Severe mechanism

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7
Q

PECRAN
Observation vs CT head for 2 years or older

A

1) Hx of LOC
2) Hx of vomiting
3) Severe mechanism
4) Severe headache

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8
Q

Canadian C-Spine Rule
High Risk Factors which mandates immobilization
YES==> ?
NO==> ?

A
  • 65 year or older
  • Severe mechanism
  • Numbness or tingling in extermities

Yes ==> immobilization
No ==> Low risk factors?

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9
Q

Canadian C-Spine Rule
Low risk factors which allow safe assessment of ROM
Yes ==> ?
No ==>?

A
  • Simple rearend MVC
  • No neck pain at scene when asked
  • No neck pain with C-spine palpation
  • Ambulatory at any time at scene

Yes==> can the patient able to actively rotate head 45 degrees?
No==> immobilization

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10
Q

Stage 1: Return to play

A

Symptom limited - activity
Daily activates do not provoke symptoms

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11
Q

Return to play
Stage 2

A

Light aerobic activities
Walking/stationary cycling at slow to medium pace - no resistance training

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12
Q

Return to play
Stage 3

A

Sport specific activities
Running or skating drills - no head impact activities

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13
Q

Return to play
Stage 4

A

Noncontact training drills
Harder training drills, passing drills
May start progressive resistive training

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14
Q

Return to play
Stage 5

A

Full contact practice
medical clearance
participate in normal training activities

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15
Q

Glasgow Coma Scale
Eye Opening Response

A

4 - Spontaneous
3 - To speech
2 - To touch
1- NR

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16
Q

Glasgow Coma Scale
Verbal Response

A

5 - Alert and orientated
4 - Confused
3 - Inappropriate words
2 - Incomprehensible sounds
1 - NR

17
Q

Glasgow Coma Scale
Motor Response

A

6 - Follow commands
5 - Localize to pain
4 - Flexion withdraw
3 - Abnormal flexion: Decorticate
2 - Abnormal extension: decerebrate
1 - No response

18
Q

Ranchos Los Amigos Scale
Level 1

A

No response to external cues

19
Q

Ranchos Los Amigos
Level 2

A

Generalized Response: non-specific, inconsistent and non-purposeful

20
Q

Ranchos Los Amigos
Level 3

A

Localized Response: Inconsistent with delay, follows simple commands

21
Q

Ranchos Los Amigos
Level 4

A

Confused and agitated

22
Q

Ranchos Los Amigos
Level 5

A

Confused and inappropriate, non-agitated

23
Q

Ranchos Los Amigos
Level 6

A

Confused and appropriate response

24
Q

Ranchos Los Amigos
Level 7

A

Appropriate and Autonomic (Robotic)

25
Q

Ranchos Los Amigos
Level 8

A

Purposeful, appropriate response; Stand by assistance

26
Q

Ranchos Los Amigos
Level 9

A

Purposeful, appropriate response; stand by assistance on request

27
Q

Ranch Los Amigos Level 10

A

Purposeful, appropriate response; modified independent

28
Q

TBI Severity
LOC

A

Mild: Less than 30 minutes
Moderate: 30 minutes - 24 hours
Severe: More than 24 hours

29
Q

TBI Severity
Alteration of consciousness

A

Mild: a moment to 24 hours
Moderate: Greater than 24 hours
Severe: Greater than 24 hours

30
Q

TBI Severeity
Post traumatic amnesia

A

Mild: 0 to 1 day
Moderate: Between 1-7 days
Severe: 7 days

31
Q

Highly Recommended measures for TBI patients
Outpatient only

A

HiMat

32
Q

Highly Recommended for TBI patients
Inpatient only

A

Coma Recovery Scale- Revised
Moss Attention Rating Scale

33
Q

What are the 6 sub scales of the Coma Recovery Scale?

A

1) Motor
2) Auditory
3) Visual
4) Oromotor
5) Communication
6) Arousal function

34
Q

What are the cut off scores for the Agitated Behavioral Scale?

A

WFL: Less than 20
Mild: 22-28
Moderate: 29-35
Severe: Greater than 35

35
Q

What are the MCID/MCD for the Disorders of Consciousness Scale

A

MDC for BI = 5.6
MCID for BI = 8.6

36
Q

What is the MDC for Community Balance and Mobility Scale in TBI patients

A

BI MDC: 9.6 or 7.5 points

NCS (2 decks)

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