Understanding Brain Injury
WELCOME to Southern Crescent
Southern Crescent TBI Center offers comprehensive care and a range of specialized TBI services to help patients all the way through their recovery.
Because individuals with a brain injury have a wide range of physical and functional challenges, our interdisciplinary medical team works together with a patient centered approach to meet the individual care plans and goals of each patent. Our rehabilitation and medical team consist of our Physicians that monitors complex medical needs, Registered Nurses, physical and occupational therapist, respiratory therapist, speech therapist, neuropsychologist, and case managers who coordinate patient stays and discharges.
About Southern Crescent TBI
Nestled on a serene 20 acre campus just south of Atlanta, SCTBI is a cutting edge in-patient healthcare facility that is dedicated to providing medical and rehabilitation services for individuals who have suffered a traumatic or acquired brain injury. Because we understand and appreciate the privacy needs for our patients and their families, the Center offers private rooms, which is unique to SCTBI. At SCTBI, our success is based on patient outcomes. For example, our Respiratory Therapy team has weaned nearly every ventilator-dependent patients. Upon discharge from Southern Crescent, our mission is for patients to reach a high level of functional independence.
Please contact us or visit the website at sctbi.com for additional information.
For Patient REFERRAL
2125 Hwy42 N. McDonough GA 30253
Most TBI occur in association with accidents or physical assaults that result in a forceful blow to the head, yet injury to the brain can occur in other ways. The CDC estimates an annual 275,000 TBI related hospitalizations. Common types TBIs include:
• ARTERIAL DISSECTIONS
• Skull Fractures
THE REHABILITATION TEAM at SCTBI
A neurologist is a physician who specializes in the medical treatment of the entire nervous system, which includes the brain, spinal cords, nerves, and muscles. This specialist is frequently involved in the initial evaluation of patient’s neurological status and may also direct the multidisciplinary rehabilitation team. In addition, the primary functions of the neurologist include: diagnosing the type of injury, recommending consultation with other physicians and health care professionals, and prescribing and monitoring medications.
Our Physician team includes: Neurologist, Orthopedic Surgeon, Internal Medicine, and Physiatrist
Advancing in Physical and Occupational Therapy
A physical therapist functions in maintaining and improving the movement of joints and limbs and is skilled in evaluating and treating problems in these areas. Physical therapists try to restore the highest level of motor function possible. For some patients, this may learning to walk again, for others it may be learning to maintain good posture while in a wheelchair. Evaluating and enhancing muscle tone, muscle strength, coordination, endurance, and general mobility are all responsibilities of the physical therapy team at SCTBI. Individualized physical therapy programs often involve retraining of functional skills, such as the ability to transfer to and from wheelchair or the ability to walk with a brace. The PT determines whether a patient requires special adaptive equipment, such a walker, and evaluates and trains patient’s ability to use the equipment.
Our Occupational Therapist functions to help individuals overcome the physical, cognitive, and perceptual problems that limit their ability to perform functional activities. The occupational therapist evaluates the patient’s ability to use upper limbs, perform fine motor skills, coordinate eye-hand movement, and use skills of cognitive function needed for self-care or activities of daily living (ADLs). The OT develops and a treatment plan, which may include exercise and reeducation on the performance of functional self care tasks, such as bathing, dressing, and grooming; and cognitive tasks such as money management, cooking, and working with tools.
Nursing Staff at SCTBI
The rehabilitation nursing staff helps to ensure a safe, supportive medical environment, 24 hours a day. Nearly all of our nurses have ICU experience. During the early stages of rehabilitation, nurses monitor, evaluate, report on, and attend to the ongoing needs of the patient. They are also responsible for reporting to and updating our Physicians and Therapist so that necessary changes can be made to medications and treatment regimens.
Importantly, the nursing staff communicates effectively with patients and their families to educate and reinforce specific multidisciplinary goals and carry out treatment plans generated by the Rehabilitation and Medical team.
Excelling in Respiratory Therapy
Our respiratory and pulmonary therapy team specialize in the techniques and technologies used to foster a patient’s to breathing and maintain open airways. Therapist at SCTBI are involved in the early stages of treatment and are responsible for maintaining the ventilator, airway management, and endotracheal tube management. We are proud to have all of our vent-dependant patients weaned off.
A neuropsychologist is a clinician with a Psy. D or Ph.D., who specializes in brain disorders involving impairments of an individual’s emotional and cognitive functioning. Neuropsychologist study the interrelationships between the brain and how individuals think and act. A neuropsychologist often assess an individuals cognition using psychometric tests and helps coordinate the remediation aspect of rehabilitation process for those who have sustain an brain injury. Sessions with the patient and psychologist may also include work to redevelop appropriate social skills and to redirect inappropriate behaviors. Our psychologist is also available to friends and families in helping to cope with many emotional issues occurring after brain injury.
Dieticians are members of the rehabilitation team who assist in the nutrition management of the patient. The dietician evaluates a patient’s nutritional needs and assist in administering a proper diet. Because a neurological damage and physical trauma can cause a person’s nutritional needs to change substantially, a special diet may be needed to help maintain proper nutrition to assist with healing as well as for problems relating to weight loss or gain, swallowing and chewing disorders, or to aid in bowel and bladder functioning. The dietician also serves an educator, providing information on proper nutrition and good eating habits to help patients control their weight and maintain good health.
Scales, Tests and Diagnostic Measures
The Rancho Los Amigos Scale
Often used to explain behavioral, cognitive and emotional changes that take place during healing
No Response: Patient appears to be in a deep sleep and does not respond to voices, sounds, light or touch.
Generalized Response: Patient reacts inconsistently and non-purposefully to stimuli; first reaction may be to deep pain; may open eyes, but will not seem to focus on anything in particular.
Localized Response: Patient responses are purposeful, but inconsistent and are directly related to the type of stimulus presented, such as turning head toward a sound or focusing on a presented object; may follow simple commands in an inconsistent and delayed manner.
Confused, Agitated: Patient is in a heightened state of activity; severely confused, disoriented and unaware of present events. Reacts to own inner confusion, fear or disorientation. Behavior is frequently bizarre and inappropriate to the immediate environment. Excitable behavior may be abusive or aggressive.
Confused, Inappropriate, Non-Agitated: Patient appears alert; responds to simple commands. Follows tasks for two to three minutes, but easily distracted by environment; frustrated; verbally inappropriate; does not learn new information.
Confused-Appropriate: Patient follows simple directions consistently; needs cueing; can relearn old skills, such as activities of daily living, but memory problems interfere with new learning; some awareness of self and others.
Automatic-Appropriate: If physically able, patient goes through daily routine automatically, but may have robot-like behavior and minimal confusion; shallow recall of activities; poor insight into condition; initiates tasks, but needs structure; poor judgment, problem-solving and planning skills.
Purposeful-Appropriate: Patient is alert, oriented; recalls and integrates past and recent events; learns new activities and can continue without supervision; independent in home and living skills; capable of driving; deficits in stress tolerance, judgment; abstract reasoning persists; may function at reduced social level.
Patient independently shifts back and forth between tasks and completes them accurately for at least two consecutive hours; aware of and acknowledges impairments when they interfere with task completion; requires standby assistance to anticipate a problem before it occurs; depression may continue; patient may be easily irritable and have a low frustration tolerance.
Patient is able to handle multiple tasks simultaneously in all environments but may require periodic breaks. Irritability and low frustration tolerance may persist when feeling sick, fatigued and/or under emotional distress.
Glasgow Coma Score (GCS)
Scored between 3 and 15*
The Glasgow Coma Score test measures the initial responses or lack of responses your loved one may have to determine the level of their brain injury.
Best Eye Response
(Scored 1 to 4)
• No eye opening
• Eye opening to pain
• Eye opening to verbal command
• Eyes open spontaneously
Best Verbal Response
(Scored 1 to 5)
• No verbal response
• Incomprehensible sounds
• Inappropriate words
Best Motor Response
(Scored 1 to 6)
• No motor response
• Extension to pain
• Flexion to pain
• Withdrawal from pain
• Localizing pain
• Obeys commands
Total made up of three sectional scores
*Always look at a GCS broken down by components – not just the total. A GCS of 13 or higher correlates with a mild brain injury,
9 to 12 is a moderate injury, and 8 or less, a severe brain injury.