Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CBIS > military service and TBI > Flashcards

military service and TBI Flashcards

1
Q

service members returning from operation Iraqi freedom

A

22% TBI and concussion
8% persistent symptoms

56% of these are mTBI
44% mTBI + PTSD

TBI = signature injury in modern warfare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

causes of TBI in modern warfare

A

explosions, gunshot wound, MVA, closed or open

issues for this population

  • mechanism of injury
  • co occurring issues of deployment
  • military culture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

peacetime related brain injuries

A

Motor vehicle accidents
Falls
Sports related
Training accidents
Working in closed spaces (e.g., tanks or submarines)
High risk behaviors after returning from duty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

4 levels of blast related injury

1. primary injury

A
  1. primary injury - direct injury from over-pressure wave, compresses air filled organs, catapults body backward

body parts - impacting lungs, GI, middle ear

ex: blast lung, tympanic injury, abdominal hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

4 levels of blast related injury

2. secondary injury

A
  1. secondary injury - energized debris or explosive fragments (shrapnel) impacts head/ body

body parts - any part

ex: penetrating ballistics (eyes) or blunt injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

4 levels of blast related injury

3. tertiary injury

A
  1. tertiary injury - body impacts wall, ground, or object

body parts - any part

ex: open or closed brain injury or fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

4 levels of blast related injury

4. quaternary injury

A
  1. quaternary injury - inhalation of toxic gasses/ substances - exacerbation of any existing conditions

body parts - any part

ex: burns, COPD, asthma, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

TBI screening - tests used by medics to screen for need for additional care

A

Military Acute Concussion Evaluation (MACE) developed by DVBIC

Provides gross measures of cognitive domains: orientation, immediate memory, concentration and memory recall

Combined with other information including LOC and PTA

TBI diagnoses made whenever alteration in consciousness exists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

military neuropsych testing pre deployment

A

Prior to deployment each service member completes a 20 minute computerized neuropsychological battery
Effects of concussion can be better determined by comparing pre- and post- injury performance
Compared if suspicion of head injury
Helps to determine return to duty (RTD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

military neuropsych test example

A

Neurobehavioral Symptom Inventory (NSI): can be used to assess the most common symptoms experienced following TBI

The State-Trait Anxiety Inventory (STAI) & the Automated Neuropsychological Assessment Metrics (ANAM): Mood and Sleep Scales, which provide focused assessment of mood and anxiety disturbance

The ANAM Simple Reaction Time and Continuous Performance subtests, which objectively measure cognitive performance

Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) measuring immediate memory, visuospatial/constructional, attention, language and delayed memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

initial tx considerations for concussion and mTBI

A

Symptom management: i.e. headaches, vision, cognition, sleep

Education: signs and symptoms, strategies, rest guidelines

Therapy

Implementation of duty restrictions: for mTBI similar to sports concussion guidelines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

return to duty considerations for mTBI

A

Clinical Practice Guidelines provide recommendations for care

Rest and RTD considerations are very important

No one is returned until symptom free at rest and exertion

BUT - Mission responsibilities may take precedence over recuperation and final decision is made by the Commander

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PTSD and mTBI

A

Individuals with TBI may have fear, anxiety, acute stress reaction and PTSD pre-injury or may follow TBI

44% of service members with concussion may meet diagnostic criteria for PTSD and mTBI

With overlap of symptoms, difficult to diagnose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Co-Occurring Disorders with mTBI

A

chronic pain, PTSD, depression, anxiety, substance misuse

These medical and psychological co-morbidities provide a diagnostic challenge given the overlap of symptoms

Physical, psychological and cognitive problems associated with TBI are also aggravated by other symptoms

Treatment focuses on symptom relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Medical discharge process

A

goes through 2 boards
medical evaluation board
physical evaluation board

determine if plan is 
return to duty, 
temporary disabled 
separate from active duty
medical discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

medical evaluation board

A

part 1 of medical discharge evaluation

physician determines if service member is able to meet medical retention standards - informal process

17
Q

physical evaluation board

A

part 2 of medical discharge evaluation

formal fitness for duty and disability determination and eligibility for disability compensation

uses scale 0-100%

18
Q

medical treatment in war zone

A

initial stabilization and treatment

evacuate through Landstuhl Regional Medical Center (Germany)

19
Q

transfer to Walter Reed Medical Center

A

from Landstuhl med. center in Germany to DC area

transfer for surgery and comprehensive TBI screen, initial rehab and surveillance for complications

20
Q

after Walter Reed initial rehab -

transfer to

A

home VA for continued tx, acute rehab, or community integration

or

polytrauma center for moderate- severe TBI ; acute rehab or community integration

21
Q

Returning home after TBI

A

after medical stability,
tx team determines medical POC that best meets recovery goals

acute management of TBI range from symptom management to aggressive management of intracranial pressure

logistics issues of family are addressed

transition is complicated by cognitive and physical and behavioral changes

22
Q

VA polytrauma system of care

A

Continuum of care from 5 regional Polytrauma Centers (PRC) to 23 Polytrauma Network Sites (PNS) to Polytrauma Support Clinics (PSC) to Polytrauma Points of Contact (POC)

Goal is to recover enough to transfer closer to home

team works with Seamless Transition Social Worker

23
Q

Defense and Veterans Brain Injury Center (DVBIC)

community reentry and rehab

A

DVBIC develops brain injury rehabilitation through civilian partnership programs for model community reintegration of service members with TBI

Those with unmet needs or with long term disability may be candidates for Community Integrated Rehabilitation (CIR)
- this is post acute not subacute

24
Q

community integrated model - neurobehavioral

A

patients have severe behavioral disturbances; needs 24 hour supervision

intensive residential behavioral care

25
Q

community integrated model -

residential community program

A

24 hr supervision / support
residential setting with community access
integrated comprehensive tx

26
Q

community integrated model -

comprehensive holistic treatment

A

need for intensive tx and benefit from increased awareness training

day programs, multimodal rehab

27
Q

community integrated model - home based program

A

able to reside at home and self direct care

may need outpatient support services

28
Q

Research for why community integrated models are beneficial

A 
Improved functional outcomes
Reduced social dependency
Increased participation
Better vocational outcomes
Improved self and family ratings

CBIS (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions