Prompt Diagnosis and Treatment of Traumatic Brain Injuries Starts in the Emergency Room

by Steven Gursten
Michigan Auto Law

The key to prompt diagnosis and treatment of a car accident victim’s brain injury starts with the doctors and medical staff in the hospital emergency room (ER). Knowing that car crashes are one of the leading causes of traumatic brain injury (TBI), they need to look for the symptoms of TBI and ask the right questions.

Unfortunately, that is not happening as effectively as it should. Research has shown that as many as 56% of TBIs are not detected in the ER. Other respected studies show that hospital ERs miss TBI diagnoses 80% of the time.

Car Accidents are a Leading Cause of TBI

The fact that car accidents are one of the leading causes of TBI in the U.S. is well-documented and undeniable: 

• “Motor vehicle crashes were the leading cause of death for persons 15-24, 25-34, and older adults aged 75 or more years.”
• “Motor vehicle crashes were the leading cause of these brain injury-related hospitalizations for adolescents and adults aged 15 to 44 years of age.”

TBI Symptoms to Watch For

Symptoms of TBI after a car accident that doctors and ER medical staff should look for include:

• Loss of consciousness
• Memory loss of events immediately before and after the crash
• Feeling dazed, disoriented or confused
• Feeling drowsy, sleeping a lot and/or difficult to arouse
• Difficulty concentrating and paying attention
• Difficulty communicating
• Slurred speech
• Headaches
• Nausea or vomiting
• Dizziness
• Balance problems
• Blurred vision
• Sensitivity to noise and light
• Ringing in ears

How to Improve Detection of Brain Injuries in the ER

To ensure individuals receive a prompt diagnosis so they can start treatment and begin the recovery process, hospital ERs should consider taking the following steps:

• Questioning patients about all TBI symptoms, not just loss of consciousness
• Questioning those at the scene about an individual’s behavior and actions both before and after a car crash to reveal memory gaps, loss of consciousness, and/or confusion or disorientation
• Using additional diagnostic testing after a negative CT scan
• Evaluating whether symptoms are indicative of both a TBI and another injury

It’s also important not to rule out TBI based on relatively short periods of loss of consciousness (e.g., less than 30 minutes).

TBIs are Often Masked Injuries

The term “masking” is used by medical professionals to describe the situation where the symptoms and intense pain of one injury are attributed to only that injury – even though they may be indicative of another, as-yet undiagnosed injury. 

This happens frequently – and far too often – with TBI, where the symptoms of a brain injury are attributed to another more obvious, more “visible” injury and the medical team overlooks the potential TBI.

To complicate things even more, we know that the brain goes into a hyper-metabolic state as it tries to protect itself after an injury. The result is that many of the symptoms we would expect to see are “masked” or prevented from appearing during an exam at the ER. These delayed car accident injuries put TBI survivors’ health at risk by interfering with getting the prompt diagnosis and treatment they need.

Dangers of a Missed Diagnosis

The dangers of missing a diagnosis are very serious: 

• Patients don’t get necessary treatment, which impairs or prevents their recovery
• Patients continue to experience TBI-related symptoms and complications and don’t have the information needed to seek necessary treatment.
• Patients may engage in activities (such as contact sports) that could put them at risk of aggravating their existing, untreated TBI.

Without prompt diagnosis and detection of brain injury, patients’ legal rights to recover benefits and compensation may be jeopardized. Individuals with brain injury and their loved ones should monitor their health after a car accident and make sure they report any new symptoms or lack of improvement to health care professionals as soon as possible. 

Steve Gursten is the immediate Past-President of the American Association for Justice’s Traumatic Brain Injury Litigation Group. He lectures across the country to personal injury lawyers on how to prove and win these cases at trial. Steve has received the highest recorded jury verdicts and settlements for traumatic brain injury cases over multiple years, including a $5.65 million jury verdict and a $4.2 million jury verdict on insurance company offers of less than $100,000.