Brain Injury – Amnesia and Confusion – A Probing Inquiry is Needed

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Posted on 11th September 2009 by Gordon Johnson in Brain Injury

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This series of blogs started with the quarterback analogy, discussing all of the things an amnestic but not confused quarterback had to do on every play. If we were to design a protocol to determine whether a quarterback was amnestic of the events of a game, any sports writer could do it. Ask the man about the plays, the winning scores, the interceptions. Especially the interceptions. If a quarterback doesn’t remember the interceptions, he is clearly suffering from amnesia.

Is it really that much harder to determine amnesia in the real world? Yes and no. We don’t have the blueprint of what the person was doing for the hour surrounding the injury like we do with an NFL quarterback. But if the person was in an automobile accident and was taken to the Emergency Room, we do have at least an idea of what might have happened to them in the last hours.
  • Question One: Tell me about the ambulance ride.
  • Question Two: Did you have to check in with billing before you got to me? If so, tell me about the process.
  • Question Three: I see you are wearing a neck brace. Who put it on? When did you begin to hurt?
See, it really isn’t that hard. We know an awful lot about what the person likely has been doing in the past hour. See if they remember the details.

When asking the questions, don’t ask simple yes or no questions. If yes or no questions are asked, use them as a simple transition to more open ended questions. If you direct the persons response with a yes or no question, you will learn very little about how they are thinking. Make them talk, recall and explain. By the time the person is seen by a doctor in the ER, it is often two hours post accident. That may be late enough to determine the beginning of issues with amnesia.

If the doctor would imagine himself a sports writer asking a quarterback about the game, our identification of amnesia in the Emergency Room could grow exponentially. It is time to move beyond the level of inquiry of the Glasgow Coma Scale.

Norwegian court rejects lawsuit by divers

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Posted on 23rd September 2008 by Gordon Johnson in Brain Injury

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Date: 9/9/2008 2:34 PM

By BJORN H. AMLAND
Associated Press Writer

OSLO, Norway (AP) _ A Norwegian court on Tuesday dismissed a lawsuit by nearly 20 divers who claim their health was seriously damaged from working at extreme depths during oil exploration in the North Sea three decades ago.

The Oslo District Court said the government could not be held legally responsible for the divers’ health problems because they were not directly employed by the government at the time. The divers had sought a total of 277 million kroner (US$49 million) in damages.

Scores of so-called pioneer divers were sent to extreme, sometimes experimental depths while working on offshore oil installations in the 1970s and 1980s, according to a government commission that studied the case. Some of them have complained of lung and brain damage.

The lawsuit was filed by 18 divers and the widow of another diver. It said the government violated the European Convention on Human Rights because it knew or should have known the risks of deep-sea diving and failed to put in place the regulations necessary to protect the divers.

The Oslo court said the government could not be held legally responsible — despite its involvement in the oil industry — because the divers were employed by diving and oil companies operating on the Norwegian continental shelf.

However, it said there was a lack of precedent and suggested a Supreme Court decision on the matter would be helpful.

“I am very surprised about the verdict,” said Marius Reikeraas, a lawyer representing the divers. “The way it looks now we will likely aim for an appeal directly to the Supreme Court.”

The outcome could bring a spate of other suits by injured divers.

The government has accepted moral and political responsibility for the divers, but rejects any legal obligation. However, in 2004, Parliament authorized compensation of nearly $500,000 for each of about 200 divers, in addition to previous payments of more than $90,000 each.

Copyright 2008 The Associated Press.