TRAUMATIC BRAIN INJURY (TBI)

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10 Terms

1
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TBI: Glasgow Coma Scale

  • Score 3-15

    • 3 = BAD

    • 15= GOOD

      • 3-8: SEVERE head injury

      • 9-12: MODERATE head injury

      • 13-15: MILD head injury

2
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TBI: Rancho Los Amigos- Level 1

    • UNRESPONSIVE to stimulation

      • Appears asleep (coma)

      • Intervention:

        • Stimuli looking for response

        • Positioning & ROM to prevent contractures

3
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TBI: Rancho Los Amigos- Level 2

  • GENERALIZE RESPONSE to stimuli

    • Not localized

    • Intervention:

      • Stimuli looking for response

      • Positioning & ROM to prevent contractures

4
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TBI: Rancho Los Amigos- Level 3

  • LOCALIZED RESPONSE to stimuli

    • Still DEPENDENT w/ADLs

    • Intervention:

      • Attempting to get localized response/attention

      • AAROM

5
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TBI: Rancho Los Amigos- Level 4

  • AGITATED

    • Intervention:

      • Assist them w/simple ADLs

      • Restrain may be necessary (physician orders required)

      • A lot of cueing and guidance (HOH)

6
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TBI: Rancho Los Amigos- Level 5

  • DISORIENTED

    • Intervention:

      • Build habits of self-orienting, checking external sources, etc

        • Ex: if you ask them what time is it? They don’t follow up w/questions or look around the environment to figure it out

      • Multi-step tasks

7
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TBI: Rancho Los Amigos- Level 6

  • USING CUES

    • Intervention:

      • Task re-learning utilizing external self cueing

        • Ex: we tape instructions to mirror to help brush teeth

8
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TBI: Rancho Los Amigos- Level 7

  • LIMITED JUDGEMENT- ADLs are ok to perform BUT NOT IADLS

    • Intervention:

      • Work on IADLs

      • Role playing is useful

9
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TBI: Rancho Los Amigos- Level 8

  • PROBLEM SOLVING

    • Interventions:

      • Routine tasks are fine

      • Difficulty one-off problems and planning

10
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MNEMONIC for Rancho Los Amigos & Interventions

“RRRANCHO”

  1. R: Response = Stimulation

  2. R: Response = Stimulation

  3. R: Response = Stimulation

  4. A: Agitated, ADLs w/ Assist = ADLs, restrains (phys orders)

  5. N: No clue what time it is = Work on self orientation (clock)

  6. C: Check your watch = Expand self orientation for Independence

  7. H: Hang off the basics, IADLs HARD= IADL practice , role-playing

  8. O: One off problems= Problem solving, work