Traumatic Brain Injury

Question 1

What is mental health promotion?

Answer 1

Really is rooted in the principles of Primary Health with an emphasis on the determinants of health: our mental health is affected by where we live, where we work, how we spend our free time and who we spend our time with.

Question 2

What is mental health?

Answer 2

Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community (WHO, 2021)

Our quality of life and our ability to enjoy life are enhanced by positive mental health and a sense of well-being (Mental Health Commission of Canada, 2021)

Question 3

What is primary prevention?

Answer 3

Primary preventionseeks to prevent disease from starting, before people have the disease

Question 4

What is secondary prevention?

Answer 4

Secondary preventionseeks to detect disease early in its progression before clinical signs and symptoms are apparent*early diagnosis and treatment

Question 5

What is tertiary prevention?

Answer 5

Tertiary prevention
once a disease has become obvious. *hopes to interrupt progression and to reduce the amount of disability

Question 6

What is a traumatic brain injury?

Answer 6

• An injury to the brain caused by a blow to the head; penetration of the skull caused by an accident.
• The injury may disrupt functioning in a single area of the brain (focal damage) or impact multiple areas of brain functioning (diffuse damage).
• Presentation depends on areas of the brain damaged.
• Adverse effects could be short term or life-long.

Question 7

What % of Canadians live with a TBI?

Answer 7

2%

Question 8

What are major causes of TBIs?

Answer 8

intimate partner violence and accidents being major causes. Women with TBI are more likely than men to experience mental health problems post-injury.

Question 9

At what rate are people with TBIs affected by depression?

Answer 9

About half of all people with TBI are affected by depression within the first year after injury. Even more (nearly two-thirds) are affected within seven years after injury.

Question 10

What % of patients experience personality change, irritability, anxiety, and depression after concussion. These neuropsychiatric symptoms are not unique, but part of the natural course following concussion.

Answer 10

50%

Question 11

What are the different types of brain injuries?

Answer 11

• congenital and perinatal
• acquired (non-traumatic like a tumor, or traumatic, open like a gunshot or closed like a fall)

Question 12

What are causes of traumatic brain injuries?

Answer 12

Falls
Assaults
Motor Vehicle Accidents
Sport/Recreation Injury
Abusive Head Trauma (shaken baby syndrome)
Gunshot wounds
Workplace Injury
Child Abuse
Domestic Violence

Question 13

What are causes of non-traumatic brain injuries?

Answer 13

Strokes (ie Haemorrhage, Clot)
Infectious Disease (ie Meningitis, Encephalitis)
Seizure
Electric Shock
Tumours
Toxic Exposure
Metabolic Disorders
Neurotoxic Poisoning (ie carbon monoxide, lead)
Lack of oxygen (ie drowning, choking)
Drug Overdose

Question 14

What aspects are assessed with a TBI in terms of severity?

Answer 14

• loss of consciousness
• amnesia
• brain imaging

Question 15

What are assessment criteria of a minor brain injury?

Answer 15

• loss of consciousness of less than 30 minutes
• amnesia of less than 1 day
• Brain imaging normal

Question 16

What are assessment criteria of a moderate brain injury?

Answer 16

• loss of consciousness of 30 minutes to 24 hours
• amnesia of 1 day to 7 days
• Brain imaging normal or abnormal

Question 17

What are assessment criteria of a severe brain injury?

Answer 17

• loss of consciousness for more than 24 hours
• amnesia greater than 7 days
• Brain imaging normal or abnormal

Question 18

What is assessed on the Glasgow Coma Scale?

Answer 18

EYE OPENING
None 1 = Even to supra-orbital pressure
To pain 2 = Pain from sternum/limb/supra-orbital pressure
To speech 3 = Non-specific response, not necessarily to command
Spontaneous 4 = Eyes open, not necessarily aware _______
MOTOR RESPONSE
None 1 = To any pain; limbs remain flaccid
Extension 2 = Shoulder adducted and shoulder and forearm internally rotated
Flexor response 3 = Withdrawal response or assumption of hemiplegic posture
Withdrawal 4 = Arm withdraws to pain, shoulder abducts
Localizes pain 5 = Arm attempts to remove supra-orbital/chest pressure
Obeys commands 6 = Follows simple commands _**
VERBAL RESPONSE
None 1 = No verbalization of any type
Incomprehensible 2 = Moans/groans, no speech
Inappropriate 3 = Intelligible, no sustained sentences
Confused 4 = Converses but confused, disoriented
Oriented 5 = Converses and oriented

Question 19

What are critical to complete when a patient falls, they have hit their head or it was not witnessed?

Answer 19

We want to ensure a head injury has not occurred, so we will initiate neuro vitals to monitor for any changes.

Question 20

What is assessed with neurovitals?

Answer 20

• LOC
• Movement
• Hand grasp
• Speech
• Pupil Reaction
• Also do Vital signs

Question 21

What is included in primary prevention for TBI?

Answer 21

Seatbelts
Helmets

Question 22

What is secondary prevention for Traumatic Brain Injury?

Answer 22

• Early Recognition and Treatment
• Glasgow Coma Scale: Accurate and early classification = quick diagnosis and treatment.
• Neuro Vitals
• Once brain injury established, the aim is to limit the development of secondary brain damage while providing the best conditions for recovery from any reversible damage that has already occurred. This involves establishing and maintaining a clear airway with adequate oxygenation and replacement fluids to ensure good peripheral circulation with adequate blood volume.

Question 23

What is involve din tertiary prevention for TBI?

Answer 23

Brain Injury Program at CCMHBI
Alberta Brain Injury Network (on BB)
Rehabilitation
Family Support
Team Approach: Psychiatry, GP, Nurses, Occupational Health, Physical Therapy, Dietician, Speech pathology, social workers

Question 24

What are some of the long term effects of brain injuries?

Answer 24

Behavioural Changes: the way a person acts (personality changes) or makes decisions can change after a brain injury. Behavioural changes include engaging in risky or impulsive behaviour, having difficulty with social and work relationships and isolation. This can be stressful and depending on the behaviour can cause safety concerns. Rehabilitation and medical teams will be able to provide practical tips for behaviour after a brain injury.

Cognitive changes: This is how the brain learns, processes information, forms memories and makes decisions. Challenges include communication, concentration, reading/writing, making decisions, and remembering things.

Emotional changes: a brain injury, a person may experience new or different emotions, including depression, anxiety, and/or anger. Emotional changes are difficult to adjust to, and it’s important to have a support system of family, friends, and medical professionals.

Physical changes: In some cases, a brain injury will have physical effects. These effects include mobility challenges, headaches, fatigue, pain and sensory changes.