version 3.0 unclassified 1 concussion/mild traumatic brain injury awareness for company commanders...

Version 3.0 UNCLASSIFIED 1

Concussion/Mild Traumatic Brain Injury Awareness for Company Commanders and First Sergeants

Insert Briefer Name Here


Part I: View TBI 101 Video

Available on Army Training Network https://atn.army.mil


● Have you ever had a concussion/mild TBI? If so, how did it happen? How did you feel after the event or during your recovery?

● Why do you think that Company Commanders and First Sergeants need to be aware of the impact of concussion/mild TBI?

● How do you think recovering from a concussion/mild TBI will impact a Soldier?

– What about his or her unit? Family?

● How can Company Commanders and First Sergeants best communicate the importance of concussion/mild TBI?

Video Discussion


Part II: Facilitated Presentation


● Understand how a concussion, also known as mild Traumatic Brain Injury (mTBI), can affect your Soldiers

● Understand how concussion impacts mission readiness

● Understand the basics of concussion

– Causes, signs, symptoms, recovery

● Discuss the actions Company Commanders and First Sergeants need to take following potentially concussive events in deployed settings

● Discuss available resources related to concussion

Lesson Objectives


Traumatic Brain Injury (TBI)

● A TBI is a disruption of brain function that results from a blow or jolt to the head, a penetrating injury to the head, or forces generated from a blast or explosion

● Penetrating brain injury

– Gunshot wounds

– Stab wounds

– Fragments

● Closed brain injury

– Mild (also known as concussion)

– Moderate

– Severe


● Concussion

– A blow or jolt to the head or forces generated from a blast or explosion that results in:

● Alteration of consciousness (temporary confusion) OR

● Loss of consciousness (passing out//blacking out) OR

● Post-traumatic amnesia (difficulty remembering part or all of the event)

– Can occur even without being knocked out/losing consciousness

● Possible causes of concussion

– Hits to the head during combat

– Hard landings during airborne operations

– Vehicle accidents

– Sports or recreational injuries

– Blasts

Concussion


Number of concussion cases in U.S. Army Soldiers worldwide from 2000 - 2011

Diagnosed Concussions

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012Q20

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

2,7483,393 3,758

4,2164,941 4,951

7,505

11,461

14,28613,994

15,395 15,759

Calendar Year in which Injury Occurred

Nu

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► The overwhelming majority of the 102,407 concussions that occurred in the Army from 2000-2011 occurred in garrison


● Goal: A cultural change following concussive events

● Vision: Every Warrior treated appropriately to minimize concussive injury and maximize recovery

● Mission: Produce an educated force trained and prepared to provide early recognition, treatment & tracking of concussive injuries in order to protect Warrior health

Army Concussion Management

Education & Prevention

Early Detection

Tracking& Treatment

Rehabilitation, Recovery &

Reintegration

Educate Train Treat Track


Impact of Concussion on Soldiers

Symptoms

• Headache

• Sleep disturbance

• Fatigue

• Dizziness/Balance problems

• Visual disturbance/Light sensitivity

• Ringing in ears

• Slowed thinking

• Difficulty finding words

• Poor concentration

• Memory problems

• Anxiety/ Depression

• Irritability/Mood swings

Manifestation

• Failure to sleep at night

• Decreased energy

• Slower reaction time

• Difficulty negotiating uneven terrain

• Easily distracted

• Difficulty processing multiple sources of information

• Interpersonal problems

Impact

• Decreased marksmanship performance

• Decreased situational awareness

• Difficulty performing quickly under time pressures

• Difficulty multitasking: such as driving a vehicle while listening to instructions over a radio

• Performance difficulties can affect self-esteem and confidence

• Fear of performing in certain operational environments


● Soldiers must see medical as soon as possible after a suspected concussion

● Every concussion is different

● Soldiers recover at varying rates and respond differently to treatment

● Most Soldiers can expect a full recovery

● Symptoms may be more severe with each additional concussion, and they may take longer to resolve

Treatment and Recovery


What Activities HELP Brain Recovery?

Cognitive (i.e. “Thinking”)

• Maximize downtime or rest during the day

• Adequate sleep at night

Physical

• Keep the heart rate low

– Stay out of the heat

– Limited physical activity

• Rest

• Adequate hydration

The Medical provider will advise when the Soldier can gradually resume cognitive/thinking and physical activities


What Activities HURT Brain Recovery?

Avoid these Physical Activities

• Exertion

– Working

– Heavy lifting

– Exercising

• Prevent second concussions while brain is healing

– No sports

– No combatives

Avoid these Cognitive (i.e. “Thinking”) Activities

• Mental exertion

– Writing reports

– Activities requiring intense concentration

– Playing video games

• Inadequate sleep

– Caffeine or “energy enhancers” that prevent proper sleep

– Irregular sleep schedule


● The medical provider will advise when it is safe for Soldiers to return to duty

● The majority of symptoms resolve with rest and proper treatment

Returning to Duty


Department of Defense Instruction 6490.11: Policy Guidance for Management of Mild Traumatic Brain Injury/Concussion in the Deployed Setting

● Mandatory events requiring command and medical evaluation and 24 hour rest period

Involvement in a vehicle blast event, collision, or rollover

A direct blow to the head or witnessed loss of consciousness

Presence within 50 meters of a blast (inside or outside)

Exposure to more than one blast event (the Service member’s commander shall direct a medical evaluation)


● HEADS acronym

– Potential symptoms following concussion

● Leaders must evaluate all Soldiers exposed to a mandatory event using the HEADS acronym

– This does not replace medical evaluation

– Soldiers need to see medical as soon as safely possible to assess for concussion

● E-mail [email protected] to order HEADS cards

Leadership Action


Medical Action

ALL Soldiers involved in a mandatory event:

• Health care providers are the only ones who can diagnose a concussion

• What can Soldiers expect during the medical evaluation?

– Medical will ask a detailed history of the injury event

– If possible a witness to the injury should accompany the Soldier to medical to help detail the injury event

– The provider or medic will perform simple tests to screen for symptoms to include memory, balance, and vision

• 24-hours downtime & re-evaluation prior to returning to duty

Soldiers involved in a mandatory event AND diagnosed with a concussion

• Minimum 24-hours downtime

• Patient education

• Testing similar to that which is used with professional athletes before returning them to play after a concussion


● TBI Training is mandated per DA EXORD 242-11 (Annex B) each year and before deployment

● All training materials are located on ATN (includes medical training)

– Type “TBI” in the Search ATN field

Additional Training Information

https://www.atn.army.mil


● Concussion continues to be a major military concern with operational impact

● Early detection, leading to appropriate treatment, is the cornerstone for successful recovery

– Company Commanders and First Sergeants should remember the HEADS acronym and perform an “eyes on” assessment as soon as possible after a possible concussion (does NOT replace medical assessment)

– Soldiers need to get checked out by medical as soon as possible

– Avoidance of a second concussion before adequate recovery is key to preventing a more serious injury

● After a concussion, Soldiers need both physical and cognitive (i.e., thinking) rest to allow the brain to heal

Key Points


Questions/Discussion

version 3.0 unclassified 1 concussion/mild traumatic brain injury awareness for company commanders...

Documents

suspected concussion

traumatic brain injury

presentation slide

garrison slide

concussive injury

basics of concussion

brain injury mild

concussion lesson objectives