Evaluating the limitations of posttraumatic amnesia 123. The westmead post traumatic amnesia scale wptas is a brief bedside standardised test that measures length of post traumatic amnesia pta in people with traumatic brain injury. Mild traumatic brain injury mtbi is a significant cause of morbidity and mortality, with many survivors of mtbi dealing with persisting difficulties for years post injury. Development and external validation of a new pta assessment scale. Reliability of the abbreviated westmead post traumatic amnesia scale in children. The scale was developed to be helpful in the early identification of cognitive impairment following mild traumatic brain injury mtbi. Post traumatic amnesia pta is a transient state of confusion, disorientation and memory loss that occurs immediately following a traumatic brain injury. Green, can you tell us more about pta and what it means for tbi patients. The misclassification rate however, is significant enough that some caution should be taken in individual cases.
Its called the westmead posttraumatic amnesia scale. The westmead pta scale is a standardised assessment tool designed to provide an objective prospective measure of pta. Ptsd symptom scale pss the following events or mark no if. The questions look at your orientation and memory of daily events. Clients diagnosed with a mild or moderate tbi are suitable for the concussion service. The westmead pta scale was designed for patients with a closed head.
Retrospective assessment of pta duration is arguably. In acute presentations the client should be assessed using the glasgow coma scale gcs and post traumatic amnesia pta score. Pdf measuring the duration of post traumatic amnesia. Backgroundposttraumatic amnesia is considered to be the best single indicator of the severity of closed head injury. Only for patients with current gcs of 15 post injury with impact to the head resulting in confusion, disorientation, anterograde or retrograde amnesia, or brief loc. Pdf use of the westmead pta scale to monitor recovery of. Other evidence does show post traumatic amnesia to be valid, and it probably remains the best simple prognostic item available. For practical reasons this also tends to be the most common clinical method. Post traumatic amnesia pta assessment of a person with traumatic brain injury should be performed on a serial basis using a validated tool, until resolution of the pta. Accurate assessment of pta is imperative in guiding clinical decision making.
It could also be used with advantage in multicentre research by providing a standard criterion for the assessment of posttraumatic amnesia. This study compared memory and attention functioning in three groups of patients. Posttraumatic amnesia and glasgow coma scale related to outcome in survivors in a consecutive series of patients with severe closedhead injury. Use of the westmead pta scale to monitor recovery of memory. When scrolling through the pages, the return to last page button will only return to the last page that was scrolled through. It is characterized a state of confusion and disorientation regarding place, time, and person. What it is the purpose of this business rule is to provide evidence based guidelines.
The wptas measures the length of posttraumatic amnesia in patients who have sustained a brain injury. Administer both tests at hourly intervals to gauge. The westmead posttraumatic amnesia scale wptas is a brief test that is often administered at the individuals bedside by a member of his or her treatment team. Reliability of the abbreviated westmead posttraumatic amnesia scale in. The westmead posttraumatic amnesia scale for children assbi. The person may be unable to state their name, where they are, and what time it is. Jul 20, 2017 awptas the eci together with the institute of trauma and injury management itim have developed a statewide abbreviated westmead post traumatic amnesia scale awptas form. The termination of pta is often abrupt except in cases where enduring memory difficulties supervene. Post traumatic amnesia scale awptas testing in the emergency department protocol for abreviated westmead cross references including nsw health seslhd policy directives sgshhs clin 155 post traumatic amnesia pta testing protocol for 1. The eci together with the institute of trauma and injury management itim have developed a statewide abbreviated westmead post traumatic amnesia scale awptas form.
The table below is used to categorise tbi at the acute presentation. Ptsd symptom scale pss foa, riggs, dancu, rothbaum 1993 hcsats 211 side 2 below is a list of problems that people sometimes have after experiencing a traumatic event. A rehabilitation program can be modified and intensified when a person is clinically assessed to be out of pta, and. Designed to measure the period of posttraumatic amnesia.
Assessment of posttraumatic amnesia after severe closed head. Its intended that clients who are likely to recover without rehabilitation support are not referred to the concussion service. The medical team and therapy team will assess a patient to determine what could be the cause of the confusion. Brief islands of memory can punctuate the period of pta. The abbreviated westmead post traumatic amnesia scale was used in 91% of patient cases and the modified oxford post traumatic scale in 7%, and of those assessed with the abbreviated westmead post traumatic amnesia scale, 94% cleared post traumatic amnesia testing within 4 h. Post traumatic amnesia is considered to be the best single indicator of the severity of closed head injury. The duration of posttraumatic amnesia is defined as the time from the moment of injury to the time of resumption of normal continuous memory.
Commence assessment for amnesia prospectively ie, before it has resolved, to increase accuracy. Our aim was to develop and externally validate a short, examiner independent and practical pta scale, by selecting the most discriminative items from existing scales and using a threeword memory test. Scale 64kb pdf pta website hosted by the department of psychology, macquarie university. Traumatic brain injury tbi instruments user manual version 5. The person may recognise family and friends but be unable to process the fact that they are in hospital or have had an injury of some kind. It consists of twelve questions that assess orientation to person, place and time, and ability to consistently retain new information from one day to another. The existence of retrograde amnesia, would also be significant, but as significant as post traumatic amnesia because of its relative rarity in a concussion. It involves both retrograde amnesia memory of past events and anterograde amnesia the ability to form new memories.
Post traumatic amnesia is also the only element with any realistic hope for being documented in a person who has a short term change in mental function around the time of the trauma. The duration of post traumatic amnesia is measured from the time a patient regains consciousness to the time the patient is able to form continuous memory. However, there has been limited empirical research investigating whether a negative gradient in retrograde amnesiarelative preservation of remote over recent memoryexists during posttraumatic amnesia pta compared with the. In clinical practice one should avoid placing too much weight on post traumatic amnesia alone. Assingle measures, posttraumatic amnesia and the glasgow coma scale gcs4 are widely considered the two best single predic. Glasgow coma scale gcs and abbreviated westmead pta scale. Post traumatic amnesia pta some patients with a head injury may be in post traumatic amnesia pta. Post traumatic amnesia, or pta, is memory loss related to a trauma. Below is a suite of resources for sites to use to support the implementation, utilisation and evaluation of the form. Retrograde personal semantic memory during posttraumatic. Sgshhs clin 155 post traumatic amnesia pta testing protocol for. Also, clicking return to last page will take you back to the previously viewed page.
Posttraumatic amnesia and glasgow coma scale related to. May be useful for people with a history of psychiatric illness, developmental or. This condition is referred to as post traumatic amnesia. Introduction of the abbreviated westmead posttraumatic. The awptas combined with a standardised gcs assessment is an objective measure of post traumatic amnesia pta. Use of the westmead pta scale to monitor recovery of memory after mild head injury. Pdf duration of posttraumatic amnesia pta is an important index of severity of head injury. The westmead posttraumatic amnesia scale wptas and its abbreviated form the awptas are also valid measures for determining the length of pta. It will show your health care team how you are recovering and how we can best help you.
Posttraumatic amnesia article about posttraumatic amnesia. Other assessments brain injury association of america. Select and use one of the available validated posttraumatic amnesia measurement tools eg, modi. Posttraumatic amnesia an overview sciencedirect topics. Posttraumatic amnesia definition of posttraumatic amnesia. Evaluating the limitations of post traumatic amnesia as a severity scale traumatic brain injuries tbi account to a third 30. Please rate on a scale from 03 how much or how often these following things have occurred to you in the last two weeks. Assingle measures, post traumatic amnesia and the glasgow coma scale gcs4 are widely considered the two best single predic. Evidencebased information on post traumatic amnesia from hundreds of trustworthy sources for health and social care. Understanding and interacting with people in posttraumatic. Tesson, stephanie a nogajski, rebecca r macey, julieanne and paget, simon p 2016. Only for patients with current gcs of 15 24hrs post injury with impact to the head resulting in confusion, disorientation, anterograde or retrograde amnesia, or brief loc. Post traumatic amnesia pta is a key symptom of traumatic brain injury tbi. The most obvious symptom is the loss of memory for the present time.
Post traumatic amnesia pta is the period of time during which a person is disorientated or confused and unable to recall new information following a head injury. A person with a severe tbi is likely to have pta for more than seven days. Pta is sometimes also referred to as post traumatic confusional state and can occur from the moment of injury until the return of continuous memory. Welcome to this presentation on the administration of the abbreviatedwestmead post traumatic amnesia scale, or the awptas, as we shall refer to it. The westmead posttraumatic amnesia scale queensland health. Recovery from tbi can be described in three progressive phases. Introduction of the abbreviated westmead posttraumatic amnesia. Post traumatic amnesia and glasgow coma scale related to outcome in survivors in a consecutive series of patients with severe closedhead injury. Posttraumatic amnesia refers to the period after a brain injury when the brain cant form any new shortterm memories. A person who experiences a moderate tbi may have pta from one to seven days following the traumatic event. Post traumatic amnesia pta is a state of confusion that occurs immediately following a traumatic brain injury tbi in which the injured person is disoriented and unable to remember events that occur after the injury.