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The 8 Levels of TBI: What You Need to Know

Brain injuries can be very serious, and symptoms and issues can develop hours or even days after the original accident. That’s why it’s important to get checked out by medical practitioners following an injury that involved any hit or bump to your head. Getting documentation about your injuries right away can help you seek compensation for damages later if necessary.

Many people don’t realize the lengthy path to health that may need to be traveled after a traumatic brain injury. Find out more about the eight stages of recovery from brain injury below, and learn how a brain injury lawyer can help.

What Is the Ranchos Scale for Traumatic Brain Injury?

The Rancho Los Amigos’ Level of Cognitive Function is one common clinical measure used to determine where someone is on the path to recovery after a traumatic brain injury. There are other clinical measures of TBI recovery. The Ranchos scale is used primarily in tracking recovery for people who have experienced a closed-head injury in slip and fall accidents or other incidents.

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A closed-head brain injury occurs when there has been no penetration of the skull. An open injury does involve penetration of the skull by an object, and the treatment protocols and recovery expectations aren’t necessarily the same for these two types of TBI.

Levels of Recovery in the Ranchos Scale

The Ranchos Scale is used in recovery settings. Individuals may be in hospitals, rehab centers where they’re receiving occupational and physical therapy, or at home. The location of the recovery often depends on where in the Ranchos Scale the person currently falls.

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The Ranchos Scale is divided into eight levels:

  • Level 1: No response. The person is unable to respond to external stimuli because they are in a coma or other vegetative state. They may move and show signs of restlessness, such as tremors, but they don’t move as a direct result of sounds or touch. This doesn’t necessarily mean the person can’t hear what is going on around them, though.
  • Level 2: Generalized response. The person is still in a partial state of coma, but they do respond to external stimuli—at least some of the time. They may move their body in response to touch or even make noises or speak to mimic sounds they are hearing around them. They are not, however, providing completely rational responses.
  • Level 3: Localized response. The person is no longer in a coma, but they aren’t able to react fully and normally to things. They may not be able to move their entire body or move it correctly or in complex ways, and they may be unable to do things they could before such as speaking, writing, reading, eating on their own, or walking. At this level, individuals may or may not recognize loved ones.
  • Level 4: Agitated and confused. In this level of recovery, someone may have to focus all their attention on the basics of life, such as eating or getting dressed. They may still need assistance with these activities and be engaging in occupational and physical therapy. Cognitive functions aren’t normal and the person can easily be confused or agitated by sensory inputs. They may become easily frightened by what is happening around them and struggle with memory and focus.
  • Level 5: Inappropriate and confused. At this point, someone recovering from a serious traumatic brain injury is less agitated but can still be confused easily. They are more able to respond to commands and pay attention to what is happening around them, but they may still struggle to organize and remember new information. Easy and common activities can usually be accomplished without help, but the person may be unable to attend to more complex tasks. At this stage, individuals are typically still in the hospital or rehab facility. They may also be at home with home health care arranged.
  • Level 6: Appropriate and confused. Individuals at this stage can typically concentrate on something for around 30 minutes and handle a number of physical and mental tasks. They may be slower to think about and respond to things than they were before the injury, and they may have to specifically concentrate to conduct certain actions or speak the correct words. At this point, individuals are not generally ready to return to work or school.
  • Level 7: Appropriate and automatic. By this stage of recovery, individuals are able to automatically perform routine tasks and don’t need help with things like getting dressed or even cleaning a home. However, concentration and other mental functions are still impaired, and the person may not have the adequate judgment to undertake activities that involve risk. It’s generally not recommended, for example, that someone drives a car or operates machinery at this point. 
  • Level 8: Appropriate and purposeful. At this level of recovery, the person can be functional at a somewhat normal level and may return to regular activity and work. However, it’s possible that the person will continue to experience some issues and reduced capacity mentally and physically when compared to their pre-injury status. Depending on the nature of the injury and other factors, this may always be the case.

Get Help With Your Brain Injury Case

As you can see, the road back from a serious brain injury can be long and expensive. If you or a loved one is dealing with a TBI, contact Jiles Law, P.A., to find out how we can help.

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