How can you focus as an LNC on shining light on the invisible wounds associated with trauma? Is your attorney client struggling to identify the potential invisible damage and devastating effects of trauma on the plaintiff?
This post aims to illuminate these overlooked neuropsychological impacts. Through four compelling case scenarios, we shed light on their profound implications for both victims and legal proceedings.
Case I: Pedestrian versus Motor Vehicle
A male was hit by a snowplow while he was at the end of his driveway taking out the garbage can. He suffered a head injury, scalp lacerations, LOC (loss of consciousness), elbow contusion, bilateral leg pain, and internal derangement of the knee.
Case 2: Motor Vehicle Head-on Collision with a Semi-Truck
The crash resulted from a head-on collision with a semi that crossed over the center line and struck the second vehicle. The driver of the car that was hit suffered a loss of consciousness (LOC) with a head injury and multiple open fractures with deformities to the arm and leg. They involved comminuted displaced fractures to the patella, tibia, and radius. She endured more than ten surgeries since the MVA to address multiple fractures in her arms and legs, wound infections, amputation, and skin flaps.
Case 3: Motor Vehicle T-Bone with Motor Vehicle
Both driver and passenger were critically injured when their vehicle was T-boned after making a turn in front of oncoming traffic. The driver suffered positive LOC with acute respiratory failure, and a hypoxic injury with fractured ribs, ankle, and hand. The passenger died of MVA-related complications.
Case 4: Construction Injury
A heavy object fell onto the worker’s head and shoulder, causing LOC, a significant cervical injury that required emergent surgical intervention, leaving him with residual pain in his neck and back. He also sustained anosmia (loss of smell), pituitary dysfunction, and cognitive as well as executive dysfunction as a result of the traumatic brain injury.
Whether the plaintiff was injured due to a fall, work-related incident, or motor vehicle collision, the impact on their overall health and well-being can be profound.
Easily visible wounds, such as burns, abrasions, lacerations, contusions, and fractures are typically straightforward to identify and document.
Personal injury attorneys often face challenges in quickly recognizing potential invisible wounds. These unseen injuries, which can significantly affect a client’s mental health and recovery, require a deeper and more detailed approach to identification and documentation.
Types of Invisible Wounds after a Traumatic Event
When considering the aftermath of a traumatic accident, it is crucial to look beyond the visible injuries and address neuropsychological effects that can significantly impact an individual’s recovery and quality of life. Pain types may include acute, chronic, breakthrough, neuropathic, phantom limb, and radiculopathy, as described below.
- Psychological trauma with ASD (acute stress disorder), PTSD (posttraumatic stress disorder), anxiety, depression, and phobias.
- Cognitive impairments with TBI (traumatic brain injury), post-concussive syndrome, memory loss, difficulty concentrating, confusion, and reduced attention span.
- Emotional distress with mood swings, irritability, grief, loss, survivor’s guilt, and depression.
- Sleep disturbances with insomnia, nightmares, racing thoughts, and sleep apnea.
- Adjustment disorders with difficulties adapting to changes after a traumatic injury and impaired daily functioning.
- Strains with interpersonal relationships impacting marital issues, family conflicts, changes in role dynamics, and isolation from friends and family.
Types of Pain – an Invisible Wound
Traumatic events can lead to a spectrum of pain experiences that impact both physical and mental health and add to the invisible wounds.
- Acute pain typically lasts less than six months and is often a result of injury, surgery, or illness. The pain usually subsides when the underlying cause is treated.
- Chronic pain is persistent pain that typically occurs for more than six months and can affect activities of daily living and quality of life.
- Neuropathic pain may be described as burning, tingling, shooting, and electrical shock sensations caused by damage to the nervous system.
- Phantom limb pain is felt in the amputated limb. Patients describe it as tingling, burning, or aching sensations.
- Radicular pain radiates from the spine to other areas of the body.
- Breakthrough pain is a sudden intense flare of pain that occurs on top of controlled pain.
- Allodynia is pain from stimuli that do not usually provoke pain such as sensitivity to touch, light pressure, or temperature changes.
Tonapa highlights that injured extremities are frequently life-threatening and associated with physical disability. Other sequelae include functional impairments, chronic pain, sleep disturbance, and depression, which can lead to a decrease in overall quality of life. Older adults often experience persistent functional impairments that can last months after the traumatic event.
Mary Beth Kerstein MSN BSN RN ONC contributed this section from her chapter in our Medical Records Analysis Vol 3 book. Read the rest by purchasing the book at this link: http://LNC.tips/buyMRA3
Pat Iyer is president of The Pat Iyer Group, which develops resources to assist LNCs in obtaining more clients, making more money, and achieving their business goals and dreams.
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