So as promised, here’s what to look out for if you suspect someone of a brain injury straight from our friends at Mayo Clinic:
Mild Brain Injury
Physical Symptoms:Loss of consciousness for a few seconds to a few minutes to no loss of consciousness, but a state of being dazed, confused or disoriented, headache, nausea/vomiting, fatigue or drowsiness, difficulty sleeping or sleeping more than usual, dizziness or loss of balance
Sensory Symptoms: Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell, sensitivity to light or sound
Mental Symptoms: Memory or concentration problems, mood changes or mood swing, feeling depressed or anxious
Moderate-Severe Brain Injury– anything above plus…
Physical Symptoms: Loss of consciousness from several minutes to hours, persistent headache or headache that worsens, repeated vomiting/ nausea, convulsions or seizures, dilation of one or both pupils of the eyes, clear fluids draining from the nose or ears, inability to awaken from sleep, weakness or numbness in fingers and toes, loss of coordination
Mental Symptoms: Profound confusion, agitation, combativeness or other unusual behavior, slurred speech, coma and other disorders of consciousness (I would think a coma would be a dead give away, but you never know I guess.)
Kids symptoms can be a little more difficult to spot, since they often can’t express what they’re feeling. Here’s what to look out for in the toddler crowd: Change in eating or nursing habits, persistent crying and inability to be consoled, unusual or easy irritability, change in ability to pay attention, change in sleep habits, sad or depressed mood, loss of interest in favorite toys or activities. Of course all these have to be correlated with a bump on the head. My nephew gets sad and easily irritable when he’s tired, but that doesn’t mean he has a brain injury.
Now for the neuro check, we have some nursing students to demonstrate:
Rather robotic, their MMT skills stink and of course you wouldn’t explain these tests using medical jargon to the patient, but you get the idea. Just a quick overview of areas to check. Many clinicians like to go head to toe so you don’t miss anything. And honestly, I don’t really ask orientation questions directly. You can figure out how oriented a person is just talking to them. Besides that, let’s be honest; half the time I don’t know what the date is either. Who cares really until you have to write it down on your documentation a bazillion and a half times? Ask something more salient if you have to… like their birthday for long term memory. Then for short term memory, with a patient introduce yourself and tell them something about yourself (your favorite color, your favorite team, etc.) on your first check and then quiz them on your name and interesting fact later on. I won’t post it here, but there was a video that popped up on the right side of the screen of the above video on YouTube of a neuro assessment on an unconscious person. Thought that might be interesting as well.