JANUARY 13, 2015, PORTSMOUTH, Va. (NNS) – Professional athletes and service members have something in common that might not be immediately obvious: they are both at risk for injuries that lead to concussions, which is a form of mild traumatic brain injury.
While initiatives started by the NFL to tackle this issue have been grabbing recent headlines, treatment programs for service members injured at home and on the battlefield are leading the way in developing the protocols to treat patients with concussions and other forms of mild TBIs.
Navy Medicine is among those taking steps to advance and standardize care of service members who may be suffering from a concussion, which led to three training sessions being offered at Naval Medical Center Portsmouth for shipboard and clinic health care providers in Hampton Roads Jan. 7 – 9.
A team from the Navy Bureau of Medicine and Surgery’s Wounded, Ill and Injured taught dozens of providers the protocols for assessing and treating mild TBI and concussions over the three days.
“Concussion awareness is critical,” said Capt. Jack Tsao, program director for BUMED’s TBI program. “It has been helpful to develop more programs and care options when people, from Congress to officials in organizations such as the NFL, see the impact of these injuries. We conduct training for our health care providers globally on a regular basis, so they are aware of what current protocols are, and they can accurately treat patients.”
Rear Adm. Elaine Wagner, deputy chief for Wounded, Ill and Injured, stressed the continued need for being prepared to treat TBIs and concussions, despite the official end of the Afghanistan and Iraq wars.
“This is a topic that is not going away just because of the ending of our last war,” Wagner said. “Of our recorded cases, 85 percent of concussion and TBI that happen to our active duty personnel are while [they are not deployed]. It is really important that our providers have an understanding of current theories and treatments to help patients with this type of injury.”
A mild TBI/concussion occurs when two conditions are met: an injury event and either an alteration of consciousness, a loss of consciousness or post-traumatic amnesia.
When a service member is believed to have this type of injury, their first-line provider will administer an evaluation called a MACE, or Military Acute Concussion Evaluation. Service members must also be allowed to rest and have downtime for a minimum of 24 hours following the potentially concussive event, even if they are not diagnosed with a concussion.
Service members who have more than one potential concussion in any 12-month period will be required to rest for additional time after their symptoms resolve. They must be re-evaluated and medically cleared before returning to duty.
“About 95 percent of people will recover from this in a week or so, but the small percentage who do not, will have to go and receive more specialized care,” Tsao said. “The overall goal of this training is to help standardize the way patients are treated for this type of injury.”
First-line providers will monitor concussion patients for more than a dozen symptoms ranging from headache, dizziness and irritability to memory problems, sleep issues and seizures. The patients can also be treated with medication to reduce headache and help other symptoms. If the symptoms persist, the patient can be referred to a facility for CT scans and more advanced treatment as required.
“As a corpsman or primary care provider, we need to be aware of procedures and policy on treating this type of injury,” said Chief Hospital Corpsman Dexter Raysor, a special operations independent duty corpsman who is currently the leading chief petty officer at the Norfolk Naval Shipyard Branch Health Clinic. “With training and guidance like this, we will hopefully be able to spot these injuries early on and accurately treat our patients.”
Some of the training was a refresher for providers who have already trained in treating concussions, while some aspects were new.
“This class was a great refresher for aspects of this injury I have already learned and use,” Raysor said. “There were also numerous other things that I have even seen for the first time here like the algorithms to help guide providers through the treatment process. As a health care provider with the potential to treat this type of injury, this training is more than beneficial. I can teach my staff about the early signs and treatment of TBI, which will greatly increase our patient care capability.”