Tbi Basics - urgency medical Care for Traumatic Brain Injury

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The first medical care after a Traumatic Brain Injury may occur at the scene of the injury, such as a fall on a building site or a motor vehicle accident, or it may occur at an crisis room where the injured person has been transported. No matter where care starts or who delivers it, paramedics or Emt's, or Er staff, the first goal is the same: to stabilize the sick person and forestall any further injury. Stabilization means insuring that the sick person has enough oxygen contribute to the brain, re-establishing quarterly blood pressure and providing for enough blood circulation to both the brain and the body.

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Particularly after an crisis or a severe fall, in which the patient's spinal cord may have been damaged, the sick person should not be moved until s/he can be located on a backboard with a neck restraint. Immobilization on a back board and with neck restraints aims to forestall further injury to the spinal cord which could consequent in greater paralysis. Once the sick person is strapped onto a backboard and the head secured in a neck restraint, s/he can be moved with reduced risk of paralysis.

If the patient's airway is blocked or compromised, it must be opened to allow enough airflow, so that the brain is not further damaged by oxygen deprivation. An crisis tracheotomy may be required, a surgical course to make an opening in the throat and allow direct passage to the trachea, or windpipe. The tracheotomy may be performed at the crisis site if necessary, or once the sick person arrives at the hospital. If the patient's heart has stopped, Cpr may be required to restart it to promote blood flow.

Once the sick person has been stabilized, medical caregivers rate the nature and extent of the brain injury. Neurological examination will comprise vital signs (pulse, blood pressure, temperature, rate of breathing) and pupils' response to light. There are any rating scales that allow medical staff to speedily collate the patient's capacities and impairment. The most widely used is the Glasgow Coma Scale, Gcs, an easy to administer 15-point test that evaluates the patient's brain function using three different indicators: eye opening, verbal response, and motor response.

Here are the Gcs indicators and their point values:

Eye Opening

4 Pt opens his eyes without prompting
3 Pt can open his eyes when asked
2 Pt only opens his eyes in response to painful stimulus
1 Pt doesn't open his eyes at all

Speech/Verbal Response

5 Pt is alert and oriented, speaks coherently
4 Pt is disoriented but speaks coherently
3 Pt speaks, language is inappropriate or incoherent
2 Pt can't speak, but can make sounds
1 Pt can't make any verbal response

Motor Response

6 Pt can move arms and legs when asked
5 Pt can move toward a painful stimulus to interrupt it
4 Pt can withdraw from a painful stimulus
3 Pt moves abnormally toward painful stimulus
5 Pt moves toward painful stimulus
1 No movement in response to painful stimulus

The scores from the three areas are added to get a total score. A score of 13 or greater indicates the proximity of a mild brain injury. Scores in the 9-12 range show a moderate brain injury, and a score of 3 to 8 confirms a severe brain injury.

The Gcs or other rating scale is not the only test used to rate the severity of a brain injury. Its value to the crisis medical team, whether at the crisis site or in the crisis room, is that it gives them very speedily some indicator of the extent of the patient's injuries, and helps them plan further, more refined appraisal and treatment. For more on evaluating brain injuries see "Tbi Basics - Evaluating the Seriousness of Your Tbi."

If you or a loved one has suffered a Traumatic Brain Injury, and you believe that it was caused or contributed to by an additional one party's negligence, you will need to consult with a lawyer experienced in working with brain injury. An experienced brain injury lawyer can help you decide whether you may have a claim against the other party. You should talk with a brain injury lawyer as soon as possible, so that your lawyer can advise you about your legal situation and advise a plan of action.

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