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Faster screening, treatment for TBI ahead

Military officials announced this week that the Defense Department will enforce a new protocol for ensuring service members with head injuries immediately get the care they need.

The system could prevent long-term cognitive problems for mild concussions, but also makes sure troops woozy from an injury don’t endanger themselves or others by going back out on patrol, said Kathy Helmick, senior director for the Traumatic Brain Injury Clinical Standards of Care Directorate at the Defense Centers for Psychological Health and Traumatic Brain Injury.

“The real push this year is for early detection,” she told attendees of the Military Health System annual conference Tuesday.

This year in the war zones, Helmick said, mandatory screening will be required by a medic or corpsman for anyone who:

• Is within 50 meters of a blast or near a building damaged by a blast.

• Is in a vehicle that has been damaged by a blast.

• Receives a direct blow to the head.

• Says he lost consciousness or was seen losing consciousness.

The medics will use an expanded Military Acute Concussion Evaluation to check service members. The MACE traditionally has contained one or two lists that medics would read to a service member and have the member recite back as a test for short-term memory loss.

Helmick said it was relatively easy for savvy service members to memorize the one or two lists so they could be cleared to go back out on patrol with their combat buddies.

The MACE now will have multiple lists, rather than only one or two.

In addition, anyone who goes through the mandatory screening process also must sit out for 24 hours of recovery, then go through a re-evaluation before they can return to duty.

Helmick also said that a service member who loses consciousness will be required to see a neurologist.

“The myth is that there isn’t a treatment, so why bother?” she said. “There is treatment.”

She said a person’s brain oxygen levels and blood pressure need to be restored to normal as quickly as possible to prevent long-term damage, such as short-term memory loss, seizures or headaches.

The military is offering a Virtual TBI Clinic for providers in Iraq and Afghanistan. Any medical provider who has questions or wants a copy of a service member’s baseline cognitive tests can e-mail tbi.consult@us.army.mil. This service is for medical providers only.

Helmick said the new guidelines are important because studies have shown that even mild concussions immediately hamper marksmanship, reaction time and concentration. Troops also may have behavioral problems or sudden changes in emotions.

“They’re suffering,” she said of injured service members. “We’re seeing these people over and over.”