Undiagnosed and untreated mild traumatic brain injuries continue to represent one of the major failings of the American medical community.
All too often, the ambulance report and the emergency room record will list “no LOC” when that statement is false.
The failure of the medical community to detect closed head injuries following car accidents results from the total and complete lack of knowledge as to how to take a proper history from the patient who has been involved in trauma that could potentially have resulted in a concussion.
Most medical doctors simply ask the patient “were you unconscious?”. The stupidity of that approach is blatant. By definition, someone who was unconscious is not conscious of the fact that they were unconscious!
Simply put, how can you logically expect someone who was unconscious to know that they were unconscious? Consider this: would you expect a person who was unconscious to know how long they were unconscious? Of course not. They told you they were unconscious for 3 minutes, or 5 minutes, or any other precise period of time, that statement would be considered to be completely incredible! Likewise, if the patient says that he or she was or was not unconscious, that statement should be considered completely incredible as well .
Accordingly, the only credible way to listen to history from trauma victim which would rule in or rule out a period of loss of consciousness is to ask the following questions: “what is the last thing you remember before the collision?” And “what is the next thing you remember after the collision?” When the answer to the first question is that the patient’s last recollection before the collision is seen the car approaching, with no recollection of the actual collision, there is credible evidence of a loss of consciousness. Further, when answer to the second question is that the patient’s next recollection is that the car was stopped in somebody was knocking on the driver’s window, there is clear and credible evidence of a loss of consciousness.
Further, the history taking should include questions about the classic symptoms of a concussion which include the following:
REMEMBER THIS: COMPLETE LOSS OF CONSCIOUSNESS IS NOT NECESSARY FOR THERE TO HAVE BEEN A CLOSED HEAD INJURY!!! (MENTAL CONFUSION AND DISORIENTATION IS SUFFICIENT)!!!
Remember that Justin Morneau suffered a closed head injury of such magnitude that he was on the disabled list for 8 months with no loss of consciousness. He got up immediately and walked off the field!