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Mon Nov 6 13:15:04 GMT 2006

In a message dated 11/6/2006 2:11:31 AM Central Standard Time,  
tangentcarrot at hotmail.com writes:

At the  hospital, he had a GCS score of 15, and had short range (few hours)  
retrograde and antegrade amnesia (he could tell he was in a hospital, but  
know how he got there or what happened. He neither remebered any of the  
events in the few hours before the incident). He was sleepy, shievering  and 
cold (it wasn't very cold there), and kept complaining about  weakness.
At the scene it was just the same, since he woke up the first  time. He was 
vomiting a lot and too weak to stand  up.

this is sounding more and more like a complex concussion, rather than an  
operable bleed. In the field, I would be doing everything I could, short of  
physically man handling the patient, to persuade him to come in to be checked  
out, and once there, would do a CT of his head to confirm this.

After that, the ideal would be to have him observed in a facility where  
Neurosurgery is urgently available if he does start to get worse....not sure  what 
the optimal would be, as many if not most of these patients do as well  at 
home with family care as they do in a community hospital, and few of them go  on 
to decompensate.

ck
Charles S. Krin, DO FAAFP

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