March is Traumatic Brain Injury Awareness Month

March is Brain Injury Awareness Month

Traumatic Brain Injury: It’s not just an injury – its people. People whose lives have been changed forever by a blow to the head or a neurological event.

Head injuries, especially those that develop into traumatic brain injuries (TBI), are a serious health risk. According to the Centers for Disease Control, “An estimated 1.7 million TBI-related deaths, hospitalizations, and emergency department visits occur in the U.S. each year. Nearly 80% of these individuals are treated and released from an emergency department. TBI is a contributing factor to a third (30.5%) of all injury-related deaths in the United States, or about 52,000 deaths annually.”

TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury. The majority of TBIs that occur each year are concussions or other forms of mild TBI

The Center for Head Injury Services also shares some sobering facts from the Coma Guide for Caregiver from the Delaware Health and Social Services, Division for Aging and Adults with Physical Disabilities:

Every 5 minutes someone dies from a head injury

140,000 people worldwide

75,000 – 100,000 in the U.S.

Over ½ of brain injury deaths occur at the time of the incident or within two hours of hospitalization

Every 5 minutes someone becomes permanently disabled due a head injury

70,000 – 90,000 of those who survive will have lifelong disabilities

2,000 more will live in a persistent vegetative state

Over 50% of those who sustain a brain injury have been intoxicated at the time of injury
The cost of TBI in the U.S. is over $48 billion each year

Buckle your child in the car using a child safety seat, booster seat, or seat belt (according to the child’s height, weight, and age).
Wear a seat belt every time you drive or ride in a motor vehicle.
Never drive while under the influence of alcohol or drugs.
Wear a helmet and making sure your children wear helmets when:

Riding a bike, motorcycle, snowmobile, scooter, or all-terrain vehicle;

Playing a contact sport such as football, ice hockey, or boxing;

Using in-line skates or riding a skateboard;

Batting and running bases in baseball or softball;

Riding a horse; or

Skiing or snowboarding.
Make living areas safer for seniors, by:

Removing tripping hazards such as throw rugs and clutter in walkways;

Using nonslip mats in the bathtub and on shower floors; Installing grab bars next to the toilet and in the tub or shower;

Installing handrails on both sides of stairways;

Improving lighting throughout the home; and

Maintaining a regular physical activity program, if your doctor agrees, to improve lower body strength and balance.
Make living areas safer for children, by:

Installing window guards to keep young children from falling out of open windows; and

Using safety gates at the top and bottom of stairs when young children are around.
Make sure the surface on your child’s playground is made of shock-absorbing material, such as hardwood mulch or sand.

What is a Concussion?

A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth. Health care professionals may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, their effects can be serious.

What are the Signs and Symptoms of Concussion?

Most people with a concussion recover quickly and fully. But for some people, symptoms can last for days, weeks, or longer. In general, recovery may be slower among older adults, young children, and teens. Those who have had a concussion in the past are also at risk of having another one and may find that it takes longer to recover if they have another concussion.

Symptoms of concussion usually fall into four categories:

Thinking/
Remembering
Physical Emotional/
Mood
Sleep
Difficulty thinking clearly Headache

Fuzzy or blurry vision

Irritability Sleeping more than usual
Feeling slowed down Nausea or vomiting
(early on)
Dizziness
Sadness Sleep less than usual
Difficulty concentrating Sensitivity to noise or light

Balance problems

More emotional Trouble falling asleep
Difficulty remembering new information Feeling tired, having no energy Nervousness or anxiety  

 

Some of these symptoms may appear right away, while others may not be noticed for days or months after the injury, or until the person starts resuming their everyday life and more demands are placed upon them. Sometimes, people do not recognize or admit that they are having problems. Others may not understand why they are having problems and what their problems really are, which can make them nervous and upset.

The signs and symptoms of a concussion can be difficult to sort out. Early on, problems may be missed by the person with the concussion, family members, or doctors. People may look fine even though they are acting or feeling differently.

When to Seek Immediate Medical Attention:

Danger Signs in Adults
In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. Contact your health care professional or emergency department right away if you have any of the following danger signs after a bump, blow, or jolt to the head or body:

  • Headache that gets worse and does not go away.
  • Weakness, numbness or decreased coordination.
  • Repeated vomiting or nausea.
  • Slurred speech.

The people checking on you should take you to an emergency department right away if you:

  • Look very drowsy or cannot be awakened.
  • Have one pupil (the black part in the middle of the eye) larger than the other.
  • Have convulsions or seizures.
  • Cannot recognize people or places.
  • Are getting more and more confused, restless, or agitated.
  • Have unusual behavior.
  • Lose consciousness (a brief loss of consciousness should be taken seriously and the person should be carefully monitored).

Danger Signs in Children
Take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and:

  • Have any of the danger signs for adults listed above.
  • Will not stop crying and cannot be consoled.
  • Will not nurse or eat.

Severe Traumatic Brain Injury

A severe TBI not only impacts the life of an individual and their family, but it also has a large societal and economic toll. The estimated economic cost of TBI in 2013, including direct and indirect medical costs, is estimated to be approximately $76.5 billion. Additionally, the cost of fatal TBIs and TBIs requiring hospitalization, many of which are severe, account for approximately 90% of the total TBI medical costs.

Types of Severe TBI

There are two types of severe TBI, each described below by associated causes:

Closed – an injury to the brain caused by movement of the brain within the skull. Causes may include falls, motor vehicle crash, or being struck by or with an object.

Penetrating – an injury to the brain caused by a foreign object entering the skull. Causes may include firearm injuries or being struck with a sharp object.

The Glasgow Coma Scale (GCS), a clinical tool designed to assess coma and impaired consciousness, is one of the most commonly used severity scoring systems.  Persons with GCS scores of 3 to 8 are classified with a severe TBI, those with scores of 9 to 12 are classified with a moderate TBI, and those with scores of 13 to 15 are classified with a mild TBI.  Other classification systems include the Abbreviated Injury Scale (AIS), the Trauma Score, and the Abbreviated Trauma Score.  Despite their limitations5, these systems are crucial to understanding the clinical management and the likely outcomes of this injury as the prognosis for milder forms of TBIs is better than for moderate or severe TBIs.

Potential Effects of Severe TBI

 

A non-fatal severe TBI may result in an extended period of unconsciousness (coma) or amnesia after the injury. For individuals hospitalized after a TBI, almost half (43%) have a related disability one year after the injury.  A TBI may lead to a wide range of short- or long-term issues affecting:

  • Cognitive Function (e.g., attention and  memory)
  • Motor function (e.g., extremity weakness, impaired coordination and balance)
  • Sensation (e.g., hearing, vision, impaired perception and touch)
  • Emotion (e.g., depression, anxiety, aggression, impulse control, personality changes)

Approximately 5.3 million Americans are living with a TBI-related disability and the consequences of severe TBI can affect all aspects of an individual’s life. This can include relationships with family and friends, as well as their ability to work or be employed, do household tasks, drive, and/or participate in other activities of daily living.

What is TBI?
Traumatic brain injury is defined as a blow, jolt or other injury to the head that disrupts the functioning of the brain. Not all blows or jolts to the head result in a TBI. A TBI can occur from exposure to blasts, falls, gunshot wounds and motor vehicle accidents. Blasts are the leading cause of TBI for active duty military personnel in war zones.

A mild TBI, also known as a concussion, may make you briefly feel confused or “see stars.” Common temporary symptoms associated with a concussion include headache, ringing ears, blurred vision, dizziness, irritability, sleep problems and problems with memory and concentration.

The symptoms of a concussion generally improve in a short period of time, usually within hours, and typically resolve completely within days to weeks.
The following tips can minimize the risk of sustaining a TBI both on the battlefield and at home:

Prevention in a other settings:
· Wear a helmet or other appropriate head gear when on patrol or in other high risk areas.
· Wear safety belts when traveling in vehicles.
· Check for obstacles and loose debris before climbing or rappelling down buildings or other structures.
· Inspect weapons prior to use.
· Verify targets and consider the potential for ricochet prior to firing a weapon.
· Maintain clean and orderly work environments that are free of foreign object debris.
· Use care when walking on wet, oily or sandy surfaces.
· Be aware of what is on the ground around you at all times when aircraft rotors are turning.
· Employ the buddy system when climbing ladders or working at heights.

Prevention at home:
· Wear your seatbelt every time you drive or ride in a motor vehicle.
· Never drive or ride with anyone under the influence of alcohol or drugs.
· Always buckle your child into an age appropriate child safety seat, booster seat or seat belt while riding in a car.
· Wear a helmet that is fitted and properly maintained while at work and while at play, if required.
· During athletic games, use the right protective equipment.
· Keep firearms stored unloaded in a locked cabinet or a safe. Store bullets in a separate secure location.
· Avoid falls in the home by:
o Using a step stool with a grab bag to reach objects on high shelves.
o Installing handrails on stairways.
o Installing window guards to keep young children from falling out of open windows.
o Using safety gates at the top and bottom of stairs when young children are around.
o Maintaining a regular exercise program to improve strength, balance and coordination.
o Removing tripping hazards by using non-slip mats in the bathtub and on shower floors, and putting grab bars next to the toilet and in the tub or shower.
o Make sure the surface on your child’s playground is made of shock-absorbing material (e.g., hardwood mulch, sand).

The Do’s and Don’ts in recovering from a concussion:
· Do maximize downtime/rest during the day (temporary impairments resolve fastest when the brain gets rest).
· Do get plenty of sleep.
· Do avoid activities such as contact sports that could result in another concussion until you are better.
· Do let others know that you’ve had a concussion so they can watch out for you.
· Do see your medical provider if you begin to feel worse or experience worsening headache, worsening balance, double vision or other vision changes, decreasing level of alertness, increased disorientation, repeated vomiting, seizures, unusual behavior or amnesia/memory problems.
· Do seek behavioral health treatment for lingering irritability and emotional changes.
· Do be patient as healing from a brain injury can take a few days.
· Do not use alcohol or drugs.
· Do not use caffeine or “energy-enhancing” products.
· Do not use aspirin, ibuprofen, or other over-the counter pain medications unless instructed by your doctor.
· Do not use sleeping aids and sedatives unless instructed by your doctor.

 

Today’s post comes to us courtesy of Ken Oswald, Safety and Security Manager for Plateau.
(keno@plateautel.com)

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