Question

a 13-year-old patient has been struck in the head with a baseball bat while playing in a baseball game. according to the coach, the patient immediately lost consciousness. what assessment findings support a field impression of a concussion and what assessment findings support a field impression of a more severe traumatic brain injury? select the signs and symptoms that support a field impression of concussion and those that support a field impression of a more severe traumatic brain injury in the table below. sign or symptom concussion severe traumatic brain injury patient remains unresponsive the entire call ○ ⊙ patient slowly regains consciousness ⊙ ⦿○ retrograde amnesia ○ ○ anterograde amnesia ○ ○ pupil is fixed and dilated ○ ○ decorticate posturing ○ ○

Explanation:

For Concussion:

• Patient slowly regains consciousness: Concussion often involves a brief loss of consciousness followed by gradual recovery.
• Retrograde amnesia: Forgetting events before the injury is common in concussions.
• Anterograde amnesia: Difficulty forming new memories after the injury can occur in concussions.

For Severe Traumatic Brain Injury:

• Patient remains unresponsive the entire call: Prolonged unresponsiveness indicates more severe brain damage.
• Pupil is fixed and dilated: Abnormal pupil responses suggest serious brain injury affecting cranial nerves.
• Decorticate posturing: This abnormal motor response (flexion of arms, extension of legs) is a sign of severe brain injury affecting motor pathways.

Now, we select the appropriate options:

Concussion:

• Patient slowly regains consciousness (already selected)
• Retrograde amnesia: Select the circle under Concussion.
• Anterograde amnesia: Select the circle under Concussion.

Severe Traumatic Brain Injury:

• Patient remains unresponsive the entire call (already selected)
• Pupil is fixed and dilated: Select the circle under Severe traumatic brain injury.
• Decorticate posturing: Select the circle under Severe traumatic brain injury.

Answer:

Concussion:

• Patient slowly regains consciousness (selected)
• Retrograde amnesia: Concussion (circle selected)
• Anterograde amnesia: Concussion (circle selected)

Severe Traumatic Brain Injury:

• Patient remains unresponsive the entire call (selected)
• Pupil is fixed and dilated: Severe traumatic brain injury (circle selected)
• Decorticate posturing: Severe traumatic brain injury (circle selected)

(Note: In the table, for each sign/symptom, the correct column's circle should be selected as per the above explanations.)