- Head injured patients are unreliable historians.
Patients with TBI may be confused, combative, or unresponsive. They may be unable able to follow commands or report pain, and concurrent drug or alcohol intoxication makes assessment even more difficult. Assume that altered mentation is caused by a head injury instead of intoxication.
Rely on inspection, auscultation, and palpation to rule in other injuries, such as a change in the patient’s facial expression when their abdomen is palpated. Remember that internal injuries cannot be ruled out, particularly those involving the spinal cord, so take spinal precautions in any patient with a head injury and altered mental status.