Traumatic Brain Injury Flashcards

Question

What is the Distinction between mild, moderate and severe (know Moderate anything less is mild and anything more is Severe)

Answer 1

GCS score Moderate: 9-12 Loss of consciousness >30mins and less than 24hrs Altered consciousness >24hrs (same as severe) Post-traumatic amnesia >1 day <7days (period of memory loss from time of trauma to recalling events) Neuroimaging: Normal or abnormal

Answer 2

- Descriptive scale used to track cognitive and behavioural recovery as patient emerges from coma** - used for communciation of status and treatment planning - patient can plateau at any level

Answer 3

1. No response: deep sleep and completely unresponsive to stim 2. Generalized response: reacts inconsistently and nonpurposefully to stimuli in a nonspecific manner 3. Localized response - patient reacts specifically but not consistently 4. Confused-agitated: heightened state of activity> behavior is bizarre and nonpurposefully relative to immediate environment 5. confused-inappropriate: able to respond to simple commands fairly consistently 6. confused appropriate: shows goal-directed behavior but is dependent on external input or direction 7. automatic appropriate: appropriate and oriented at home and hospital settings --> judgement still impaired 8. purposeful appropriate: able to recall and integrate past and recent events and aware of and responsive to environment

Answer 4

- questions include: name, city, recall of how patient is, where he or she is and day, date month year and event of injury - Helps determien outcome or prognosis

Answer 5

Predictors of poor outcome are: - Low initial GCS score - Lower education level - Very young age (<7) and older age >40yrs - Longer periods of post-traumatic amnesia <34 days likely to have good recovery

Answer 6

- primary PT objective: prevent secondary complications (due to prolonged immobility r from TBI) --> begin mobilization when ,edically cleared - Cognitive and behavioral impairments make examination and treatment difficult --> PT must understand how to work with pts impairments PT also plays important role in patient and family education (educate transfers, about the condition, treatment, behaviors that are displayed bc of injury)

Answer 7

1. Consistency 2. Expect NO carryover 3. Model Calm behaviour 4. Expect Egocentricity 5. Flexibility/options 6. Safety

Answer 8

- interact and address inappropriate behaviors in a consistent manner (unemotional criticism) - seen by same PT at same place and same time everyday - estabilish a routine - familiarity can be calming - HELP re-orient the pt in non-threatening manner (don't ask pt to provide orientation if they are not expected to succeed): "remember I told you we have therapy in an hour?"

Answer 9

- teaching NEW skills may be unrealistic - work near patients physical level and use familiar tasks, rater than trying to progress more challenging skills that require learning - may be able to perform automatic skills (procedural memory) - ambulation, brushing teeth - does not mean any learning took place - pictures, graphs and charts will help recaall prior days therap

Answer 10

- PT calm and focued affect and behavior - pt lacks control of their behavior and feels unsafe - PT msut be in control pf their behavior and help model appropriate behavior

Answer 11

- may not see another point of view - pt will only think of themselves and appear selfish - AT THIS STAGE DO NOT STRESS THE PATIENT TO SEE OTHERS POV : sometimes if another patient and therapist passing the ball - our pt may grab it not thinking how the other patient might feel - instead of explaining to them that is is not okay to do that - REDIRECT their attention or ask to be included

Answer 12

- pt likely to have short attention span - be prepared with numerous activities that they may be directed to - treat pt at an appropriate age level - when safe - give control to patient --> allow patient to choose between therapeutic activities (do you want to bike or pass the ball aorund)

Answer 13

keep pt and those around them safe