Page 147 - ATP-P 11th Ed

MILD TRAUMATIC BRAIN INJURY (mTBI) PROTOCOL

SPECIAL CONSIDERATIONS SECTION 1
1. Mandatory events requiring MACE:
a. Personnel in a vehicle associated with a blast, collision or rollover
b. Personnel within 150 meters of a blast
c. Personnel with a direct blow to the head
d. Command directed evaluation
2. DO NOT allow a patient with an mTBI to return to duty while they are symp-
tomatic. This puts them at significant risk for greater injury (to include death) if
they sustain another head injury while still symptomatic.
3. mTBI is primarily a clinical diagnosis. If you do not feel that a patient is back to
their baseline, do not allow them to RTD and consult a medical provider.

Signs and Symptoms
1. Red Flags (Symptoms)
a. Neurological
i. Witnessed loss of consciousness
ii. Amnesia/memory problems
iii. Unusual behavior/combative
iv. Seizures
v. Worsening headache
vi. Cannot recognize people
vii. Disoriented to time and/or place
viii. Abnormal speech
b. Eyes
i. Double vision
c. General
i. 2 or more blast exposures within 72 hours
ii. Repeated vomiting
iii. Weakness
iv. Unsteady on feet
Management
1. Consider mTBI (concussion) in anyone who is dazed, confused, “saw stars,” lost con-
sciousness (even if just momentarily), or has memory loss that results from a fall, ex-
plosion, motor vehicle crash, or any other event involving abrupt head movement, a
direct blow to the head or other head injury.

136 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 137