Traumatic Brain Injury 101: Causes, Consequences - PowerPoint PPT Presentation

Loading...

PPT – Traumatic Brain Injury 101: Causes, Consequences PowerPoint presentation | free to download - id: 253452-NTNkM



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Traumatic Brain Injury 101: Causes, Consequences

Description:

Traumatic Brain Injury 101: Causes, Consequences – PowerPoint PPT presentation

Number of Views:114
Avg rating:3.0/5.0
Slides: 62
Provided by: shawnee8
Learn more at: http://www.biaoh.org
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Traumatic Brain Injury 101: Causes, Consequences


1
Traumatic Brain Injury 101 Causes, Consequences
Strategies
February 28, 2008
2
Brain Injury Association of Ohio
  • State Office-Columbus
  • CSN 1, Toledo Christine Veronie
  • CSN 3, Cleveland Lori Surtman
  • CSN 5, Lima Jennie Horner
  • CSN 8, New Philadelphia Chris Curtiss
  • CSN 11, Columbus Rich Haddix
  • CSN 12, Caldwell Jenny Rucker
  • CSN 13, Cincinnati Peggy ONeill
  • CSN 15, Marietta Cindy Auker

3
Objectives
  • Increase knowledge of demographics scope of
    brain injury
  • Gain understanding of common consequences and
    challenges following brain injury
  • Better understand the impact on the individual
    and his or her family
  • Learn about available sources of information
    assistance the lack of a home agency.
  • Identify skills and strategies to assist
    individuals with brain injury

4
What is a Brain Injury?
  • Acquired Brain Injury (ABI)
  • Traumatic Brain Injury (TBI)

5
Acquired Brain Injury
  • Any injury to the brain that occurs after birth
    as a result of
  • Physical force (due to an accident)
  • Tumors
  • Strokes
  • Violent Acts (e.g., gun shot wound)
  • Infectious Diseases (e.g., encephalitis)
  • ABI is the broadest category and includes all
    brain injuries that occur after birth.

6
Traumatic Brain Injury
  • A brain injury from an external force
  • Vehicle accidents
  • Violent Acts (e.g., gun shot wound)
  • Falls
  • Physical Abuse
  • Sports Injuries

7
Severity Continuum
  • Things to Consider
  • Symptomology
  • Pre-injury functioning
  • Symptoms vary

Mild
Severe
Moderate
8
  • 15 of all TBIs are considered moderate to severe
  • 85 of all TBIs are considered mild

9
Mild Brain Injury
  • Traumatically induced physiological disruption of
    brain function as manifested by at least one of
    the following
  • Loss of consciousness (often measured by the
    Glasgow Coma Scale
  • Loss of memory for events immediately before or
    after the accident (not longer than 24 hours)
  • Alteration in mental state at the time of the
    accident (e.g., feeling dazed, disoriented, or
    confused) and/or
  • Focal neurological deficits that may or may not
    be transient.
  • (Glascow Coma Scale score 13-15)

10
Moderate Brain Injury
  • A loss of consciousness that lasts from a few
    minutes to a few hours
  • Confusion lasts from days to weeks
  • Physical, cognitive, and/or behavioral
    impairments last for months or are permanent
    and/or
  • Persons with moderate traumatic brain injury
    generally make a good recovery with treatment or
    successfully learn to compensate for their
    deficits.
  • (Glascow Coma Scale score 9-12)

11
Severe Brain Injury
  • Severe Brain Injury (Glascow Coma Scale score 8
    or less)
  • Almost always results in prolonged
    unconsciousness or coma, brain contusions,
    hematomas, damage to nerve fibers and axons,
    and/or anoxia
  • Often results in permanent physical, behavioral,
    and/or cognitive impairments
  • Significant improvements are generally made
    during the first year and continue thereafter
  • (Glascow Coma Scale score 3-8)

12
  • Every 23 seconds, one person in the United States
    sustains a brain injury.

13
Epidemiology
  • An estimated 5.3 million Americans have a
    long-term or life long need for help with
    activities of daily living as a result of TBI
    (est. 227,000 Ohioans)
  • An estimated 1.4 million people will sustain a
    TBI each year in the United States.
  • Of these
  • 50,000 die
  • 235,000 are hospitalized
  • 1.1 million are treated and released from an ER
  • The number of people with TBI who are not seen
    in an ER or who receive no treatment is unknown.

14
Disability Prevalence Rates
400,000 with Spinal Cord Injuries
500,000 with Cerebral Palsy
2 million Americans with Epilepsy
3 million with Stroke disabilities
4 million with Alzheimers Disease
5 million with persistent mental illness
5.3 MILLION WITH TBI DISABILITY
7.3 million Americans with mental retardation
National organizations web sites, 4/00 Slide
source Brain Injury Association of
America 227,000 Ohioans - Estimate of adults
living w/disability due to TBI - source CDC
15
Leading Causes of TBI
  • 1st Falls (among elderly and very young)
  • 2nd Vehicle accidents, bicycle, or
    pedestrian-vehicle incidents (account for most
    hospitalizations)
  • 3rd Violent acts
  • 4th Sports accidents An estimated 90 are mild
  • and go unreported
  • (BIA of America Fact Sheet)
  • (109 Rehabilitation of Persons with TBI)

16
  • If you have a brain injury, you are 3 times more
    likely to get another. After the second injury,
    the risk for the third injury is 8 times greater.

17
Who experiences brain injuries?
  • Extremely Diverse
  • Highest risk 0-4 years, 15-24, and 75 years and
    older
  • Males are 1.5 times more likely than females to
    experience TBI
  • 70 of people who incur TBI recover completely
  • 15 remain symptomatic for the remainder of their
    lives
  • Alcohol is reported to be associated with 50 of
    all TBI

18
  • TBI is the leading cause of death and disability
    for children, adolescents, and young adults in
    the United States. 90,000 of those injured will
    sustain permanent injuries.
  • (www.biausa.org)

19
Neuroanatomy and Physiology of the Brain
  • Deficits vary depending upon location and
    severity of brain injury
  • Major Brain Areas
  • Frontal Lobe
  • Parietal Lobe
  • Temporal Lobes
  • Occipital Lobe
  • Cerebellum
  • Brain Stem

20
Frontal Lobe (Almost always sustains injury due
to coup-contra-coup boney undersurface of skull)
  • Motor output
  • Problem Solving
  • Self-monitoring
  • Expressive language organization (i.e., speech)
  • Personality
  • Emotions
  • Inhibition of Behavior

21
Parietal Lobe
  • Sense of touch
  • Sensory integration
  • Spatial perception
  • Visual perception
  • Identification of size,
  • shape, color

22
Temporal Lobe
  • Auditory projection (interpretation of
    speech)/Receptive language
  • Memory of new information
  • Sequencing
  • Hearing

23
Occipital Lobe
  • Vision

24
Cerebellum
  • Balance
  • Coordination
  • Skilled motor activity

25
Brain Stem
  • Breathing
  • Arousal and consciousness
  • Sleep/wake cycles
  • Attention and concentration
  • Heart rate

26
Living with a Brain Injury The Impact on the
Individual
  • Physical
  • Cognitive
  • Social
  • Behavioral Emotional

27
Physical Disabilities
  • Headaches
  • Dizziness
  • Chronic pain
  • Seizures
  • Decreased coordination
  • Loss of limbs or use of limbs
  • Nerve Damage (i.e., optic nerve, facial palsy)
  • Sensory limitations (visual disturbances, hearing
    loss, decreased taste and smell, increased
    sensitivity to noise and light)

28
Cognition
  • Broad range of symptoms that occur independently
    or in combination
  • Memory impairment
  • Impaired attention
  • Inability to remain on task
  • Difficulty focusing on thoughts, words, events
  • Deficits in language use
  • Deficits in visual perception

29
Cognition-Deficits in Executive Skills the
thumbprint of brain injury
  • Inability to self-monitor and inhibit responses
  • Poor initiation
  • Difficulty sequencing steps and completing
    activities
  • Poor judgment

30
Social
  • Difficulty attending to social cues
  • Relearning appropriate social skills
  • Loss of friends
  • Loss of familiar activities
  • Loss of self
  • Personality changes
  • Problems with emotional control
  • Susceptible to mood and anxiety disorders
  • Increased risk of suicide
  • Egocentric

31
Behavioral and Emotional
  • Frustration
  • Irritability
  • Restlessness
  • Anxiety
  • Low motivation
  • Depression

32
Behavioral and Emotional Cont.
  • Aggression- reactive, triggered by modest or
    trivial stimuli, non-reflective, not
    pre-meditated, non purposeful, explosive and
    periodic, impulsive
  • Exhibits socially inappropriate behavior
  • Disinhibition
  • Cognitive fatigue and/or physical fatigue can
    significantly impact all areas of functioning

33
Medications
  • Presently, there are no FDA approved treatments
    for cognitive, emotional, or behavioral
    impairments due to TBI.

34
Medications
  • Often on multiple medications
  • SSRIs (e.g., Prozac) often prescribed for anxiety
    and depression
  • Anticonvulsants (e.g., Tegretol) often prescribed
    to prevent seizure activity or to treat
    behavioral problems
  • Sleep medications (e.g., Melatonin) often
    prescribed for sleep disturbances
  • Neuroleptics (e.g., Risperdal) prescribed for
    psychosis and/or aggression
  • Need for continued re-assessment

35
Substance Abuse
  • Higher rates of substance abuse
  • Effects 28-32 of individuals with TBI

36
Cognition- Reasoning and Problem-Solving
  • Difficulty analyzing situations
  • Inability to draw conclusions and make decisions
  • Lack of logical thinking

37
Living with Brain Injury The Impact on Support
Systems (e.g., family, friends, employer)
  • Grieving
  • Stress
  • Survival Adaptations

38
Grieving
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

39
Stress
  • Economic Strain
  • Estimates for average lifetime cost of care for a
    person with severe TBI exceed 4 million
  • Changed Family goals and roles

40
Practical Adaptations/Accommodations
41
Signs in Loss of Attention/Concentration
  • Confusion
  • Rambling Conversations
  • Staring
  • Unable to finish a task
  • Difficulty attending to more than one thing at a
    time

42
Strategies to Help with Attention/Concentration
  • Get individuals attention before beginning a
    discussion
  • Reduce unnecessary noise or unneeded materials on
    desk
  • Limit the amount of information presented
  • Pace the work with short work periods followed by
    brief breaks

43
Signs of Memory Loss
  • Confusion regarding appointments or daily
    schedule
  • Unable to remember tasks from day to day
  • Unable to remember new information
  • Confabulates (makes up stories to fill memory
    gaps this is not lying)

44
Strategies to Help with Memory Loss
  • Establish consistent schedule
  • Structure tasks
  • Provide written cues (memory book, chart, etc.)
  • Provide verbal cues (initial sounds, choices)
  • Use compensatory tools (alarm, watches,
    calculators)
  • Link new information with old information

45
Signs in Loss of Reasoning/Problem Solving
  • Ineffective problem solving
  • Inappropriate and potentially harmful decisions
  • Unable to make inferences
  • Disorganized thinking
  • Difficulty drawing conclusions
  • Rigidity in changing plans

46
Strategies to Help in Reasoning/Problem Solving
  • Instruct and post note for Stop and Think
  • Help identify the problem and possible solutions
  • Help predict consequences
  • Break the task down into several easier steps
  • Write steps in notebook/planner

47
Signs in Loss of Impulsivity/Poor Self Control
  • Acts or speaks without considering the
    consequences
  • Inappropriate comments to or about others
  • Lower tolerance for frustrating situations
  • Inappropriate laughing or crying
  • Get stuck on one idea or thought

48
Strategies to Help in Impulsivity, Poor Self
Control
  • Encourage the person to slow down and work
    through task
  • Provide verbal and/or nonverbal feedback in a
    supportive way
  • Respond to inappropriate ideas, but maintain
    focus on original discussion
  • Expect the unexpected
  • Provide alternatives for inappropriate or
    perseverative behavior
  • Give frequent and consistent positive
    reinforcement
  • Remove the individual from a frustrating task or
    environment

49
Signs of Impaired Self-awareness, Difficulty with
Social Situations
  • Lack of awareness of deficits and limitations
  • Inaccurate self-image/self perception

50
Strategies to Help with Impaired Self-awareness,
Difficulty with Social Situations
  • Anticipate lack of insight
  • Prompt accurate self-statements
  • Use feedback generously in a positive way
  • Give realistic feedback as you observe behavior

51
Signs of Problems with Conversations
  • Does not respond to another persons
    conversation, questions or comments
  • Does not start, or is slow to start
    conversations, ask questions, or make comments
  • Leaves long pauses
  • Has difficulty explaining what he or she means

52
Strategies to Help with Conversations
  • Encourage the individual to participate, e.g.,
    ask What do you think about that?
  • Ask open-ended questions Tell me about…
  • Give time to organize thoughts
  • Give the individual your full attention and allow
    them to complete the thought
  • Re-phrase what the person has said, Do you mean…

53
Signs of Non-verbal Communication
  • Poor eye contact
  • Does not understand non-verbal cues
  • Stands to close
  • Uncomfortable number/type of physical contacts
  • Body language/facial expressions dont seem to
    match what is said (flat affect)

54
Strategies to Help with Non-verbal Communication
  • Ask the person to maintain a comfortable distance
  • Politely ask the individual to modify their
    physical contacts explain that you are
    uncomfortable with such contact
  • Tell the person you are confused by the
    difference in body language and spoken message
  • Ask the person what he or she is feeling
  • Politely ask the individual to stop distracting
    movements

55
General Suggestions
  • Structure the environment
  • Break tasks into component parts
  • Pace the work (consider headaches, fatigue, etc.)
  • Help develop organizational systems
  • BE CONSISTENT

56
Remember the Fatigue Factor!
  • Both cognitive and physical fatigue often impact
    multiple areas of functioning

57
Brain Injury Association of Ohio Services
Supports
  • Information Resource Coordination
  • Helpline
  • Community Support Network (CSN) field offices
    located throughout the state
  • Education Training
  • Peer Support
  • Outreach Prevention
  • Advocacy

58
The Ohio Plan

59
Resources to Remember
  • TBI Technical Assistance Center at NASHIA
    (National Association of State Head Injury
    Administrators)
  • http//www.tbitac.nashia.org/tbics/
  • Brain Injury Association of America (Their
    mission is to create a better future through
    brain injury prevention, research, education and
    advocacy) www.biausa.org
  • Brain Injury Association of Ohio (BIAOH)
  • 1-866-644-6242 www.biaoh.org

60
Thats All Folks!
Thank You
61
Logan
  • Logan Regional Hospital
  • Phone (435) 716-5010
  • Deb Smith
  •  
  • Bear River Health Department
  • Phone (435) 792-6510
  • Sandra Hoggan
  • TBI Support Group
  • Options for Independence
  • Phone (435) 753-5353
  • Vicki Smith
About PowerShow.com