TBI, Rancho Los Amigos, Concussions 1/11 Flashcards
(27 cards)
What type of TBI- open or closed?
Gun shot wound, knife or sharp object penetration skull fragments, direct trauma
open - direct penetration through skull
What type of TBI- open or closed?
Concussion, contusion, hematoma, injury to extracranial blood vessels?
closed - No penetration through the skull
What type of TBI- open or closed?
Hypoxia, drug overdose, near drowning, acceleration or deceleration injuries
closed - No penetration through the skull
what type of TBI injury - primary or secondary?
Skull penetration, skull fractures
primary - initial injury to brain during impact
what type of TBI injury - primary or secondary?
Contusions to gray and white matter
primary - initial injury to brain during impact
what type of TBI injury - primary or secondary?
Hematoma, hypoxia, ischemia
secondary - Damage as a response to initial injury
what type of TBI injury - primary or secondary?
Increased intracranial pressure, post traumatic epilepsy
secondary - Damage as a response to initial injury
Level of consciousness?
State of unconsciousness, unresponsive to all internal and external stimulus
coma
Level of consciousness?
General unresponsiveness with arousal from repeated stimulus
stupor
Level of consciousness?
State of consciousness person in state of sleep, reduced alertness to arousal, delayed responses to stimuli
Obtundity
Level of consciousness?
State of consciousness person is disoriented, confused, agitated, loud
Delirium
Level of consciousness?
State with quiet behavior, confusion, poor attention, delayed responses
clouding of consciousness
what grade of concussion? and what next?
- no loss of conscioussness
- transient confusion
- symptoms resolve in 15 min
- full memory of event
grade 1
athlete removed from competition and return if symptom free after 1 week of rest
what grade of concussion? and what next?
- moderate injury with transient confusion
- symptoms last >15min
- poor concentration and retrograde or anterograde amnesia
grade 2
immediately remove athlete from competition, get medical evaluation
- CT scan if symptoms worsen
- return to play if asymptotic for 2 weeks during rest and exertion
what grade of concussion? and what next?
- any form of loss of conscioussness
grade 3
immediately go to ER for full neuro eval
hospitalize if altered consciousness or mental status persists
- withhold athlete from competition unless symptom free at least 1 month
- grade 3 is secondary to diffuse axonal injury if severe can result in coma
rancho level of cognitive function?
deep sleep, Completely unresponsive to any stimuli
level 1
no response
rancho level of cognitive function?
- Reacts and consistently and non-purposefully to stimuli and non-specific manner
- Response is limited and same regardless of stimulus
- Response may be physiological changes, gross body movements, and or vocalization
level 2
generalized response
rancho level of cognitive function?
- Reacts specifically but inconsistently to stimuli
- responds directly to type of stimuli
- may follow simple commands - close eyes, squeeze hand in inconsistent, delayed manner
level 3
localized response
rancho level of cognitive function?
- Heightened state of activity, bizarre behavior, behavior non-purposeful relative to environment
- Does not discriminate among person or objects
- Unable to cooperate with the treatment efforts
level 4
confused agitated
rancho level of cognitive function?
- Verbalizations incoherent and or inappropriate to environment
- May make confabulations
- Gross attention to environment is brief, no selective attention
- Lack short and long-term recall
- bizarre agitated behavior
level 4
confused agitated
rancho level of cognitive function?
- Goal directed behavior but dependent on external input or direction
- Follow simple directions consistently
- Shows carryover for relearned tasks
- Responses may be incorrect due to memory problems but appropriate situation
- Past memories show more depth and detail then recent memory
level 6
confused appropriate
rancho level of cognitive function?
- Able to respond to simple commands fairly consistently
- If increased complexity of command or lack of external structure, responses are non-purposeful and random
- Gross attention to environment but highly distractible and unable to focus on specific task
- Inappropriate use of objects
level 5
confused inappropriate
rancho level of cognitive function?
- With structure may converse and social automatic level for short periods of time
- Verbalization inappropriate and confabulatory
- Memory severely impaired
- Unable to learn new information
level 5
confused inappropriate
rancho level of cognitive function?
- Appropriate and oriented in home or hospital setting
- Go through daily routine automatically robotlike
- Minimal to no confusion
- Carryover for new learning at decreased rate
- Judgment impaired
- With structure able to initiate social and recreational activities
level 7
automatic appropriate
