Repetetive questioning...question.

[DwayneEMTP]

I’ve found that repetitive questioning is common with trauma, and head injuries specifically. I know that doesn’t come as a surprise to anyone, but I seem to have noticed that the more “damaged” a person is, the shorter the questioning ‘loop’, as well as the time between it being repeated. Know what I mean?

For example, patient A hit her head on the floor after fainting. Approx. every five minutes or so a “loop” seems to reoccur. “What happened? Am I OK?, Who is watching after my kids?”, etc.. Until she seems content with the answers. Assessment continues until the ‘loop’ begins again.

Patient B, severe physical assault involving head and other areas. Blood/fluid in ears/nose/mouth/severe mandibular swelling. His ‘loop’ starts “Who in the hell called you a**holes!!!”, “Am I going to live?”, and repeats approx every 1- 1 1/2 minutes or so.

The more severe cranial trauma (Based on MOI, external exam and LOC) seemed to have the shorter loop, repeated more frequently.

These are just “seems to be” observations of course, as I’ve only dealt with 15-20 traumas involving this phenomenon, so I’m not pretending that I’ve discovered something factual, only something of interest.

So my question is; is there a cause/effect relationship, when present, between the length of time between the ‘loops’ and/or the duration of the ‘loop’ itself, as it relates to the severity of trauma?

Thanks for your time…

Dwayne

[LisaO925]

I’ve found that repetitive questioning is common with trauma, and head injuries specifically. I know that doesn’t come as a surprise to anyone, but I seem to have noticed that the more “damaged” a person is, the shorter the questioning ‘loop’, as well as the time between it being repeated. Know what I mean?

For example, patient A hit her head on the floor after fainting. Approx. every five minutes or so a “loop” seems to reoccur. “What happened? Am I OK?, Who is watching after my kids?”, etc.. Until she seems content with the answers. Assessment continues until the ‘loop’ begins again.

Patient B, severe physical assault involving head and other areas. Blood/fluid in ears/nose/mouth/severe mandibular swelling. His ‘loop’ starts “Who in the hell called you a**holes!!!”, “Am I going to live?”, and repeats approx every 1- 1 1/2 minutes or so.

The more severe cranial trauma (Based on MOI, external exam and LOC) seemed to have the shorter loop, repeated more frequently.

These are just “seems to be” observations of course, as I’ve only dealt with 15-20 traumas involving this phenomenon, so I’m not pretending that I’ve discovered something factual, only something of interest.

So my question is; is there a cause/effect relationship, when present, between the length of time between the ‘loops’ and/or the duration of the ‘loop’ itself, as it relates to the severity of trauma?

Thanks for your time…

Dwayne

With my vast knowledge of text book reading ( ) from the past 3 months, I am going to suggest a control group experiment.

Take 10 individuals:

The first 5, hit in the head in a manor to create the textbook cranial injuries including, but not limited to, racoon eyes, battle signs, (and if your really good) some bleeding in the ears and nose.

The other 5, tap in the head lightly, just enough to create the "loop".

Write down your findings What you do with them afterwards is up to you

[firedoc5]

Repetitive questioning of the patient, especially with a head injury or poss. CVA/TIA is a must. I've known some that have kept a time log of it.

One thing I was taught, and later experienced first hand is the cycle of questions a patient may keep repeating. The grandfather of my god-daughter had an MI along with TIA and he kept asking the exact same questions in the exact same order at the exact same intervals. The doctor was even impressed on how consistent he was.

[Doczilla]

It's called persevorating, and it is not limited to trauma. Altered mental status from any cause can lead to this. I don't know if there is any relationship between severity of the brain insult and length of the loop.

'zilla

[KAThomas]

It's called persevorating, and it is not limited to trauma. Altered mental status from any cause can lead to this. I don't know if there is any relationship between severity of the brain insult and length of the loop.

'zilla

Thank you...

As I read the first few responses I couldn't recall the technical term but they cover this in most Pre-Hospital Trauma Life Support/ Advanced Trauma Life Support (PHTLS/ATLS) courses. And you're also taught never to dismiss this as Alz or Dementia even with a past Hx but to look at the kinematics foremost.

[akflightmedic]

It's called persevorating, and it is not limited to trauma. Altered mental status from any cause can lead to this. I don't know if there is any relationship between severity of the brain insult and length of the loop.

'zilla

How do you say that?

Can you do it phonetically with the emphasis where it needs to be?

Is it per sev o rating?

[Eydawn]

Purr *sev* uh rate. (My translation since I never could read the frickin' dictionary version...)

Perseverate.

Per Dictionary.Com

Wendy

CO EMT-B

[Richard B the EMT]

Only witnessed it one time, a minor head injury to a 5 year old male. Kept repeating the same line of questions to his mother, and only faltered one time, said, "I mean..." and resumed the repetitive questioning of his mother.

[Just Plain Ruff]

so Lisa which control group are you volunteering for?