TBIs

Glasgow Coma Scale

3 = bad

15 = good

GSC 3-8

severe head injury

H8 to be severe

GSC 9-12

Moderate head injury

GSC 13-15

Mild head injury

Lucky #13 to be mild

Ranchos Los Amigos can be also be used for…

Strokes and other brain injuries

Rachos 1

Unresponsive to stimulation (Coma)

Interventions: try to elicit response, positioning, ROM to prevent contracture

Ranchos 2

General response to stimuli (may squirm w/ sternal rub)

Intervention: same as 1

Ranchos 3

Localized response to stimulus; can attend to some stimuli

Intervention: attempt to get localized responses/attention; AAROM

Ranchos 4

Agitated; may need assist in BADLs

May need restraints

Ranchos 5

Disoriented

Build habits of self-orienting, checking external sources; mutli-step tasks

Ranchos 6

Using cues

Task re-learning utilizing external self-cueing

Ranchos 7

Limited Judgement

work on IADLs, role-playing

Ranchos 8

Problem-solving

Routine tasks are fine, but difficulty with one-off problems and planning

Ranchos Mnemonic

RRRANCHO