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Letter of Transmittal

Mild traumatic brain injury (TBI) arises from a jolt; blow or penetrating wound in the head which is accompanied by a change in the mental status as the person experiencing the trauma becomes dazed, unconscious, disoriented or confused (Halbauer et al. , 761). The memory dysfunction aspects last for less than 30 minutes during injury time or symptoms on the neurological or neuropsychological functions onset later. Many solders at Fort Carson survive blast injuries because of improved torso protection as insurgent enemies from Iraq and Afghanistan use improvised explosive devices to attack (Snell & Halter, 24).

However, these soldiers sustain head and neck wounds and also shockwaves from roadside bombs can ripple through the soldiers’ brain and cause damage which may not leave visible scars but cause a lasting mental and physical harm to the soldiers (Halbauer et al. , 758). Nevertheless, many soldiers go undiagnosed and untreated for mild traumatic brain injury caused by explosives prompting the condition to be termed as a ‘signature wound of war as the injuries are often undetected until the soldiers are back home and try to lead normal lives but fail (Snell & Halter, 24; Zeitzer and Brooks, 347).

1. 1. Problem Statement The Fort Carson military medical system is failing to diagnose brain injuries in troops who served in Iraq and Afghanistan. So many soldiers go undiagnosed and receive little or no treatment for lingering health problems associated with mild traumatic brain injury. The current intervention at the military is derived from assessments of TBI sufferers from motor accidents and sports injuries yet studies show that these injuries are different from the ones resulting from detonating improvised explosive devices.

There is need to pursue the right therapeutic interventions to assist soldiers lead a normal civilian life after the combat. 1. 2. Purpose The purpose of this report is to investigate whether the screening and treatment methods administered to soldiers with mild traumatic brain injury at Fort Carson are really working, and to propose a better intervention. 1. 3. Objective • To use the information gathered to educate the soldiers and families of Fort Carson about the signs and symptoms of mild traumatic brain injury, and show them the kind of intervention that they need to pursue.

1. 4. Background A joint NPR and ProPublica study investigated how the military health departments handle brain injury and the findings revealed that over 40 percent of the Fort Carson soldiers had mild traumatic brain injuries which went undetected by the Army health screenings. Almost half of all the Fort Carson soldiers come back from war with some kind of brain injury, and the number continues to rise yet the military stopgaps put in place to detect them are not working.

The current method to screen soldiers for mild traumatic brain injury entails a one page questionnaire which is given three to five days after the soldiers’ return and again after 90 to 180 days. If the soldiers show signs of mild traumatic brain injury, they get checked out by a doctor, but the screenings are not significantly reliable. Fort Carson offers a Warrior Transition Unit designed to be a sheltering way station in which the injured soldiers can recuperate then return to duty or gently process out of the Army (Dao & Frosch).

The soldiers are prescribed a concoction list of medications for depression, anxiety, headaches and nightmares rather than being referred to a specialist who can deal with the problem appropriately and give them the right therapeutic intervention. What is the right screening method and treatment for mild traumatic brain injury? 1. 5. Significance and justification Substantial studies have focused on mild traumatic brain injury as a common condition especially from sports and motor accident injuries but none has suggested a therapeutic solution for soldiers whose condition result from detonation of improvised explosives (Snell & Halter, 24).

The motivation behind this research is that the soldiers as well as their family members, who are directly affected by the soldiers’ condition, need to know the kind of treatments to fight for to ensure proper care for mild traumatic brain injury. 1. 6. Research Questions 1. What problems exist with the current screening and treatment processes of mild traumatic brain injury for the soldiers at Fort Carson? 2. What problems currently exist with the Warrior Transition Units at Fort Carson for soldiers that have mild traumatic brain injury? 3.

Why are Fort Carson soldiers being prescribed a laundry list of medications instead of being referred to specialists for the proper treatment of their mild traumatic brain injury? 4. Are there new treatment options for Fort Carson soldiers that have mild traumatic brain injury? 5. What are the signs and symptoms associated with mild traumatic brain injury? 2. 0. Discussion 2. 1. Signs and symptoms associated with mild traumatic brain injury TBI has an effect on the cognitive, behavioral, physical and emotional dimensions of the sufferer (Pach).

People suffering from mild TBI experience cognitive problems for instance difficulties in thinking and thus become poor problem solvers, attention deficits, memory problems, mood shift, anxiety, headaches, and frustration. However, despite the magnitude nature of TBI, most people are unaware of the scope of the condition. Mild TBI can cause a person to lose consciousness, become confused, or disorient for at most 30 minutes. Sleeplessness is also another symptom associated with mild TBI.

On the other hand, persons with severe TBI experience the same symptoms but which last for more than 30 minutes (Zeitzer and Brooks 347). Considering that both kinds of traumatic brain injury have a negative dramatic impact in the sufferer’s life, rehabilitation conditions need to be put in place. According to Snell & Halter (25) the injuries from mild-TIB were seen as inconsequential during the early years of war in Iraq. However, the significance and potentiality of the problem has gained more momentum as the number of the sufferers increases.

Lew, Jerger, Guillory and Henry (921) study shows that auditory problems are also common in blast related TBI with hearing loss and tinnitus forming the highest number of auditory disorders. The problem is that clinical management of tinnitus does not adhere to any standards and therefore audiologists do not have adequate training for the management of the condition. However, the number of soldiers reporting hearing disorders is on the increase and thus there is need for some appropriate clinical intervention for diagnosis and management of the condition for the veteran population (Lew, Jerger, Guillory and Henry, 924).

Loss of auditory function also hinders the rehabilitation process and thus the overall therapeutic intervention is undermined. Halbauer, et al. (757-759) categorizes the TBI symptoms into nosological clusters composed of cognitive dysfunctions. Neurobehavioral clusters for instance mood swing, anxiety, stress; somatosensory disruptions in which senses are impaired; somatic symptoms in which chronic headaches are reported, and substance dependence in which the sufferers become addicted to the prescription medication.

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