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From Army Times:

The Army wants soldiers to get the message: Mild traumatic brain injury is a physical wound, not a behavioral issue. So it has launched a new campaign to reverse its “cultural attitude” against the injury, one of the signature wounds from the Iraq and Afghanistan wars, according to a recent Army message.

Since 2000, soldiers have suffered more than 91,000 concussions, the highest number of any service, as of May 16, according to military figures. The injury can have long, debilitating effects if gone untreated.

During the campaign, the Army is looking to teach soldiers and units how to identify, care for and track cases of mTBI. The Army has called for all units to immediately adopt the plan, according to the message.


A newly required annual class called “TBI awareness for soldiers” is designed to teach troops the basics about the injury. A second class for deploying soldiers will emphasize why it’s important to detect head trauma, judge its severity, offer first-level care and protect soldiers from multiple concussions.

Training for medics will include more advanced ways to identify head injuries, such as measuring speech fluency, motor skills and memory, as well as methods of patient triage and transport.


Recording what the Army calls “mandatory events” is necessary to protect soldiers against the danger of multiple head injuries. Concussions in rapid succession can compound damage done to the head, according to the message. “Mandatory events” encompass being within 50 feet of a blast, surviving a vehicle rollover or collision and suffering a direct blow to the head.


To help soldiers remember mTBI indicators, the Army created “HEADS.” “H” stands for headaches or vomiting; “E” for ear ringing; “A” for amnesia, or altered or loss of consciousness; “D” for double vision or dizziness; and “S” is a catch-all, short for “something feels wrong or is not right,” according to the message.


One rule of thumb for the program is, if soldiers experience a “mandatory event,” they must be assessed for a head injury before returning to duty. Second, a soldier who demonstrates signs of head trauma should in most cases be pulled from duty and given a 24-hour recovery period until evaluated by medical personnel, who can determine when troops are fit to return.


The “All Army Activities” message, numbered 214/2011, was sent on behalf of the Office of the Surgeon General. Commanders with questions can call 703-325-6170, a line to a representative from the Army Medical Command. For training packages, visit the Army Training Network at and search for “TBI.”

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