Tuesday, May 12, 2009


This week i have had an interesting case - a 69 year old male who was admitted to hospital due to an unwitnessed fall resulting in facial and head fractures, a head injury and rib fractures. His GSC was 3/15 - identifying a serious head injury! 3 is also the total minimum score

He presents with the following symptoms of a head injury:
-sensitivity to light/sound
-poor attention/concentration
-poor orientation (person and time)
-lack of understanding of reasoning for being in hospital
-impaired short term memory
-saying bizarre things e.g. "the particular month is"
-extreme tiredness

I have commenced the PTA with this patient
Day 1 4/7
Day 2 5/12
Day 3...
From reading though my teck notes on PTA severity and if the patient stays in PTA for longer than 7 days this can be further classified as very severe head injury. Its sad to say but the longer the length of PTA the worser the outcomes...

After discussing my observations with my supervisor - we were able to determine that the patient was able to communicate basic "needs" e.g. thirst

It would be interesting to know if there has been any personality changes and get some information about pre-accident functioning so i can hand over to the rehab team

I have decided to do some reading about head injuries

McWilliams, S. (1996). Head injury. In Turner, A., Foster, M., & JOhnson, S. E. (Eds.), Occupational therapy and physical dysfunction/. Principles, skills and practice (pp 463-469). New York: Churchill Livingstone.

1 comment:

~Jess~ said...

Overall this was a great case! I learnt so much about head injury acute management and got to write a handover report to the rehab team inclduing social history, prior functioning, OT intervnetion, current functioning and goals for rehab!
It was great also becuase the patient began to get 11/12 and 12/12 just before he was transfered! - however he still showed signs of a severe head injury and needed some intensive rehab. best of luck for him!