4 killed, 2 hurt in Pangasinan road crashes, reported August 24, 2017, Inquirer
5 hurt as train hits ambulance, reported July 7, 2017, Inquirer
3 dead, 5 hurt in Quezon road accidents, reported May 30, 2017, Inquirer
Casino staff, guests among 37 killed in Manila, reported June 2, 2017, CNN
11 killed in shooting incidents in Metro Manila overnight, reported June 2017, GMA
The list of accidents, violence, and drug abuse-related news are fed to us everyday. It has reached many layers of our awareness about the happenings in our society – economically, politically and socially that we can’t just shake our heads and walk away.
Sadly, most of these reported beats reflect more deaths than possible survivors. While writing this article, I thought: “Have we really gone this mad or reckless? careless?”
Anyway, not to get off topic with my emotions on this, the point of my writing is to raise awareness about traumatic brain injury that is one of the possible consequences of these unfortunate scenarios to the survivors.
Motorcycle and car accidents, falls, sports and recreation injuries, strong blows to the head, concussions (to shake violently), ballistic pieces shattering into the skull, and other injuries penetrating or non-penetrating the skull can cause a serious traumatic brain injury. Other less common causes of this include substance abuse (drugs), stroke, complications from surgery or sickness-related and the like.
Traumatic Brain Injury or Acquired Brain Injury (TBI/ABI) is the result of abrupt external forces acting on the skull and the brain, as when a moving object (bullet, club, baseball) strikes the head or when a moving head strikes a stationary object such as an automobile dashboard, tree or sidewalk (Brookshire, 2015).
The brain being made of soft tissue is cushioned with spinal fluid and encased in a protective shell of our skull. With strong blows or impact, the brain can jolt and move around your head causing injury to the nerves, bruises, and damage to the blood vessels.
Death or Disability and the Quality of Life
In the case of traumatic brain injury, a person’s fate either results to an end of life or to living with disability and long-term complications.
Road Accidents. Distracted driving due to texting, alcohol use, violation of traffic rules and road rage are all contributing factors to the volume of cases we have on road accidents resulting to death or injuries. The use of helmets while riding a motorcycle, for instance, is one of the traffic rules we are very familiar with. It is advocated by the National Highway Traffic Safety Administration and Motorcycle Safety Foundation. According to research, in 2010 alone, 6,941 Filipinos died from road-related accidents and a thousand more was said to make up the percentage that suffered from injury and disability (www.wpro.who.int)
Violence. A study conducted by Consunji, Rafael et.al (2011) titled “A profile of deaths among trauma patients in a university hospital: The Philippine experience” cited as to how the Philippine General Hospital’s Division of Trauma witnessed 231 or 4.7% deaths out of 4,947 patients admitted (covering periods from January 2004 to June 2007) were related to vehicular crashes, stab wounds, gunshot wounds, and multiple organ failures.
Substance Abuse. Drug abuse affects a person’s mental health. More than the psychological aspect of “mental health,” the physical human brain is in fact compromised with drug abuse resulting to failures or inability to coordinate and perform specific life-sustaining functions. Compulsive drug abuse, translating to addiction, damages the brain stem, the cerebral cortex and the limbic system. The brain’s anatomy and functions tell us that (1) the brain stem is responsible with controlling basic functions needed to maintain average functioning of heart rate, breathing and sleeping; 2) the cerebral cortex has various areas responsible for processing information from our senses (seeing, hearing, feeling, tasting), ability to think, plan, make decisions, and solve problems; and (3) the limbic system connects together brain structures important in regulating the ability to feel pleasure and the perception of emotions. This is important as the limbic system is activated through healthy “life-sustaining activities”– primarily via eating and socializing!
Effects of traumatic brain injury could be mild, severe or profound. It is classified as mild if the loss of consciousness and/or confusion or disorientation is shorter than 30 minutes. Headaches, difficulty in thinking, memory problems, mood swings, frustration, and attention deficits may transpire however commonly overlooked.
Severe brain injury is associated with loss of consciousness for more than 30 minutes and with memory loss after the injury lasting for longer than 24 hours. This is also most likely to happen in cases where an object penetrating the skull has not been removed for more than 24 hours. Physical limitations in movements of arms and legs, loss of thinking ability or emotional problems, and speech and language functional difficulties are likely to occur.
Individuals with profound traumatic brain injuries are left in long-term unresponsive states. Consequences are truly dramatic and life-changing for the patients and their families. This involves not being able to go back to their careers, social and community functions, families, and interpersonal and intrapersonal relationships, as unawareness to the environment and the “self” (may have no concern for own safety) are possibly evident.
Survivors and Rehabilitation
Speech Language Pathologists assess cognitive communication for traumatic brain injury patients. One good resource is the checklist developed by Sheila MacDonald, SLP which she called CCCABI or the Cognitive Communication Checklist for Acquired Brain Injury. Speech therapy sessions are essential to the trans-disciplinary rehabilitation for a traumatic brain injury patient.
Speech language pathologists or communicative disorders assistants facilitate the speech therapy sessions. They are working together to target specific functional difficulties, which may be all or a combination of the following goals: awareness, orientation, auditory comprehension and information processing, expression and social communication, reading comprehension, written expression, thinking, reasoning, problem solving, self regulation, and executive functions.
I will provide examples and situations in my next writing about these specific functional difficulties to help in your understanding of the importance of speech therapy for patients with acquired / traumatic brain injury.
For now, let’s pay attention to how we can make our community, our houses, and roads a safer place, and how we can raise that level of self-awareness and alertness to things or situations that can be detrimental to our own safety. In simple words, BE MINDFUL.
Also, don’t just shake your head and walk away
Bookshire (2015).Introduction to Neurogenic Communication Disorders., p 287.