Term
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Definition
| Closed or Open Head Injury |
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Term
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Definition
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Term
| Caused by an external physical force; producing a diminished or altered state of consciousness; resulting in impairements of cognition, physical performance, behavioral function, and emotional function |
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Definition
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Term
| Every __ minutes in US, one person dies and another becomes disabled from TBI |
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Definition
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Term
| __ to __ million people yearly aquire a TBI |
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Definition
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Term
| ___ million people living with permanent disabilities |
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Definition
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Term
| Children aged 0-4 years, older adolescents aged 15-19 years, and adults aged 65 years and older are ___ likely to sustain a TBI. |
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Definition
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Term
| Males aged 0-4 and adults aged 75 years and older have the ___ rates of TBI-related hospitalization and death |
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Definition
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Term
| What percentage of TBI's are caused by MVA? |
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Definition
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Term
| What percentage of TBI's are caused by Falls? |
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Definition
35.2%
-50% of TBI in 0-14 yo
-61% of TBI in >65 yo |
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Term
| What percentage of TBI's are caused by Assault? |
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Definition
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Term
| What percentage of TBI's are caused by struck by/against (sports)? |
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Definition
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Term
| What gender make up the majority of TBI injuries for all age groups |
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Definition
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Term
| What are 3 types of primary damage? |
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Definition
Focal injury
Diffuse axonal injury
Hypoxia/anoxia |
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Term
| Contusions and lacerations with or without skull fracture; coup or counter coup |
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Definition
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Term
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Definition
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Term
| Global damage is associated with poorer outcomes. Lack of O2 to brain for a period of time. |
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Definition
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Term
| What are 4 types of Secondary Damage? |
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Definition
Increased ICP
Hematoma
Infections
Seizures |
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Term
| Name 3 types of hematomas |
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Definition
Epidural
Subdural
Intracerebral |
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Term
| Bleeding within the brain which causes swelling |
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Definition
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Term
| Flexion of the UEs and extension of the LEs |
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Definition
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Term
| Extension UEs and extension LEs |
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Definition
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Term
| Which posture is worse; decorticate or decerebrate? |
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Definition
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Term
| When is the Glasgow Coma Scale done and what do the scores mean? |
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Definition
Done initialy in ICU or ER
13-15 = mild
9-12 = moderate
Less than 8 = severe |
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Term
| Name 8 common problems following TBI |
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Definition
1. Impaired affect
2. Impaired arousal and attention
3. Aphasia
4. Impaired motor function
5. Impaired cognition and behavior
6. Impaired sensory/ perception
7. Impaired balance and anticipatory reactions
8. Impaired respiratory functions |
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Term
No response: Total Assistance
- Complete absence of observable change in behavior when presented visual, auditory, tactile, proprioceptive, vestibular or painful stimuli |
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Definition
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Term
Generalized response: Total assistance
-Demonstrats generalized reflex response to painul stimuli.
-Responds to repeated auditory stimuli with increased or decreased activity
-Responds to external stimuli with physiologic changes generalized, gross body movement and/or not purposeful vocalization
-Responses noted above may be same regardless of type and location of stimulation
-Responses may be significantly delayed |
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Definition
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Term
| What are some possible treatments for Rancho Levels 1 and 2? |
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Definition
-PROM
-Positioning
-Pressure relief
-Coma/Sensory Stimulation (visual, auditory, olfactory, tactile, and taste)
-Stretching
-Splinting |
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Term
| Joint calcification due to being bedridden. Bony end feel. Seen a lot in hips. |
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Definition
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Term
Localized Response: Total Assistance
-Demonstrates withdrawal or vocalization to painful stimuli
-Turns toward or away from auditory stimuli
-Blinks when strong light crosses visual field
-Follows moving objects passed within visual field
-Responds to discomfort by pulling tubes or restraints
-Responds inconsistently to simple commands
-Responds directly related to type of stimulus
-May respond to some persons (esp family and friends) but not to others |
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Definition
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Term
| What are the treatments for Rancho Level 3? |
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Definition
-Continue: pressure relief, positioning, stretching, splinting
-Progress PROM to AROM and functional reaching tasks
-Sitting upright with decreasing trunk support
-Progress to standing if tolerated (Standing frame or tilt table) |
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Term
Confused/Agitated: Maximal Assistance
-Alert and in heightened state of activity
-Purposeful attempts to remove restraints or tubes or crawl out of bed
-May perform motor activities such as sitting, reaching and walking but without any apparent purpoe or upon another's request
-Very brief and usually non-purposeful moments of sustained alternatives and divided attention
-Absent short term memory |
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Definition
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Term
| This rancho level may cry out or scream out of proportion to stimulus even after its removal. May exhibit aggressive or flight behavior. |
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Definition
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Term
| This rancho level may have mood swings from euphoric to hostile with no apparent relationship to environmental events. Unable to cooperate with treatment efforts. Verbalizations are frequently incoherent and/or inappropriate to activity or environment. |
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Definition
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Term
| The rancho level when patients can be agitated, restless, or aggressive. Restraints may be common when unsupervised. Should minimize restraint use. May also use soft mits or safety enclosure beds. |
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Definition
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Term
| What are some treatments for Rancho Level 4 |
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Definition
-Behavior Modification
-Progress to motor activities such as reaching, standing, and walking
-Start initiating funcitonal activities and hobbies into treatment if possible
-Work near pt's functional level (don't push too hard) |
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Term
| Name some ways to deal with a patient when they become agitated. |
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Definition
-Consistency is important
-Always keep your cool
-Have to be flexible with treatment plan
-Approach pts in a calm non-threatening manner
-Prevent escalation into agitated behavior
-Use a minimal number of staff
-Avoid restraints when possible
-Family may assist in calming pt
-Control the tx environment
-Treat when pt is least tired |
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Term
| What should you do when pt starts escalating into an agitated state? |
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Definition
-Protect other pts
-Use their deficits such as hemiparesis to keep you safe
-Decrease noise
-Talk in calm voice
-Dim lights
-Let pt lie down
-Get pt away from what is causing the agitation |
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Term
Confused, Inappropriate, Non-Agitated: Maximal Assistance
-Alert, not agitated but may wander randomly or with a vague intention of going home
-May become agitated in response to external stimulation, and/or lack of environmental struture
-Not oriented to person, place, or time
-Frequent brief periods, non-purposeful sutained attention
-Severely impaired recent memory, with confusion of past and present in reaction to ongoing activity |
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Definition
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Term
-Absent goal directed, problem solving, self-monitoring behavior
-Often demonstrates inappropriate use of objects without external direction
-May be able to perform previously learned tasks when structured and cues provided
-Unable to learn new info
-Able to respond appropriately to simple commands fairly consistently with external structures and cues |
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Definition
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Term
-Responses to simple commands without external structure are random and non-purposeful in relation to command
-Able to converse on a social, automatic level for brief periods of time when provided external structure and cues
-Verbalizations about present events become inappropriate and confabulatory when external structure and cues are not provided. |
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Definition
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Term
| Since Rancho Level 5 is the level when patients are confused and inappropriate, what are some treatment techniques? |
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Definition
-Behavior modification
-Trying to flee (may need to lock the unit, safety enclosure bed, restraints, use a wander guard, or provide 24 hour supervision)
-Sexually inappropriate
-Inappropriate interactions with other patients/families/staff |
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Term
| This level needs a lot of structure in their daily routine yet therapy needs to be flexible. Continue with gross motor activities such as walking, functional tasks, hobbies, and age appropriate activities. |
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Definition
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Term
| Start introducing cognitive activities when walking such as path finding, finding objects, finding patients room or wheelchair, orientation activities. This is the level in which other injuries may become apparent. |
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Definition
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