Module 5 TBI Flashcards
When to use Glasgow Coma scale (GCS)
for TBI to categorized the severity as severe, moderate, or mile
What are the 3 response score on the GCS
motor response, verbal response, and eye opening
Severe GCS
8 or less
Moderates GCS
btw 9 -12
Mild GCS
13 - 15
Mild TBI
LOC - 0-30min
AOC - brief > 24hr
PTA - 0-1 day
GCS - 13-15
neuro image - normal
Moderate TBI
LOC - >30min and <24hr
AOC - >24 hr
PTA - >1 and <7 days
GCS - 9-12
Neuro image - normal or abnormal
Severe TBI
LOC - >24hr
AOC - >24hr
PTA - >7 days
GCS - <9
Neuro imaging - normal or abnormal
Post-traumatic amnesia (PTA)
length of time btw the injury and the time at which the pt is able to consistently remember ongoing events, and is also an important factor in predicting recovery
Decorticate rigidity
UE are in flexed posture and the LE are extended
Decerebrate rigidity
both UE and LE are postilion in extension
Coma Recovery Scale - Revised
recommended to assess pt with disordered consciousness
CRS-R subscales
auditory, visual, motor, oromotor, communication, and arousal
Disorders of conscious Scale
measures arousal and neurobehavioral recovery in pt with disorders of consciousness
DOCS tests
social knowledge; taste/swallow; olfactory function, proprioception; tactile sensation; auditory function; visual function
LOCF - I. NO Response
pt appears to be in a deep sleep and is completely unresponsive to any stimuli
LOCF - II. Generalized Response
pt. reacts inconsistently and nonpurposefully to stimuli in a nonspecific manner. Responses are limited and often the same regardless of stimulus presented. Responses may be physiological changes, gross body movements, and/or vocalization
LOCF - III. Localized Response
pt. reacts specifically but inconsistently to stimuli. Responses are directly related to the type of stimulus presented. May follow simple commands such as closing eyes or squeezing hand in an inconsistent, delayed manner
LOCF - IV. Confused-Agitated
pt. is in a heightened state of activity. Behavior is bizarre and nonpurposeful relative to immediate environment. Does not discriminate among persons or objects, is unable to cooperate directly with treatment efforts. Verbalizations frequently are incoherent and/or inappropriate to the environment; confabulation may be present. Gross attention to environment is very brief; selective attention is often nonexistent. pt lacks short and long term recall
LOCF - V. Confused-Inappropiate
pt. is able to respond simple commands fairly consistently. However, with increased complexity of commands or lack of any external structure, responses are nonpurposeful, random, or fragmented. Demonstrates gross attention to the environment but is highly distractible and lacks ability to focus attention on a specific task. With structure, may be able to converse on a social automatic level for short periods of time. Verbalization is often inappropriate and confabulatory. Memory is severely impaired; often shows innapropiate use of objects; may perform previously learned task with structure but is unable to learn new info.
LOCF - VI. Confused-Appropriate
pt. shows goal-directed behavior but is dependent on external input or direction. Follows simple directions consistently and shows carryover for releamed tasks such as self care. Responses may be incorrect due to memory problems, but they are appropriate to the situation. Past memories show more depth and detail than recent memory.
LOCF - VII. Automatic - Appropriate
pt. appears appropriate and oriented within the hospital and home settings; goes through daily routine automatically but frequently robot-like. Pt. shows minimal to no confusion and has shallow recall of activities. shows carryover for new learning but at a decreased rate. With structure is able to initiate social or recreational activities; judgement remains impaired
LOCF - VIII. Purposeful-Appropriate
pt. is able to recall and integrate past and recent events and is aware of and responsive to environment. Shows carryover for new learning and needs no supervision once activities are learned. May continue to show a decreased ability relative to premorbid abilities, abstract reasoning, tolerance for stress, and judgement in emergencies or unusual circumstances
Sensory Stimulation
an intervention to increase the level of arousal and elicit movement in individuals with low levels of arousal
