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\f0\fs24 \cf0 SGT, I got him. I got him! Check the rest of the squad!\
Hello, I'm General Pete Chiarelli. \ Our nation is currently being tested, both
at home and abroad. \ For our brave troops fighting overseas, this
test sometimes brings great sacrifice. Some of our men and women serving overseas are
returning with serious injuries, \ including Traumatic Brain Injuries, or TBIs.\
Sometimes, these injuries are obvious, and they're quickly treated. \
But often, brain injuries are not immediately visible. \
This makes them no less real.\ A concussion, clinically known as a mild traumatic
brain injury, \ can be difficult to detect. \
The diagnostic challenge is widespread and not limited to the military. \
Football players, boxers, people who have been in car accidents, \
or who have slipped and fallen \'96 \ all are cases of people who may have sustained
a TBI and need medical evaluation.\ Those who have been exposed to a potentially
concussive event \ or believe that they have, \
must be appropriately evaluated, treated, \
protected from future exposures, and, if their condition warrants, \
sent for further evaluation and treatment.\ Due to the possible significant physical and
mental effects of concussion, \ we now have protocols that mandate medical
evaluation after specific events \ where the risk for concussion is high. \
The risk of TBI in Soldiers has made this a priority for leadership.\
We believe that early and appropriate diagnosis, evaluation, \
and treatment can shorten the time it takes to return to duty \
or to the highest level of function possible. \
This applies to injuries during deployment and at home station. \
Most individuals who sustain a concussion can expect a full recovery \
with no lasting mental or physical effects. \
If not quickly identified, evaluated and treated, \
a TBI can affect not only the individual injured, \
but their families as well, long after the injury event. \
Together, we can increase awareness, \ we can foster understanding, \
and we can help welcome those who have survived a brain injury \
back into our families, our units, our workplaces, and our communities. \
Thank you for your continued strong support.\ I\'92m Lieutenant General Eric Schoomaker,
\ the Army Surgeon General \
and Commanding General of the Army Medical Command. \
A major objective of Army and DoD medicine \
is to develop the best process to evaluate and treat \
every Service member involved in an event that may result in concussion. \
The Military Health System \ and the Department of Veterans Affairs \
provide state-of-the-art care from the point of injury \
through acute treatment and rehabilitation. \
The programs are centered on the Airmen and the Family, \
with an emphasis on primary care and case management, \
and as needed other highly skilled professionals will be brought into your care. \
Traumatic brain injury or TBI is a disruption of brain function from a hit, \
a blow or jolt to the head, or a penetrating head injury that disrupts brain function.
\ Traumatic brain injuries can range from mild
\ or injuries that are called concussions to
severe and penetrating injuries. \ Mild traumatic brain injury, \
which the doctors and scientists call mTBI or mild TBI, \
is known by the general public as concussion. \
So, when we talk about the spectrum of traumatic brain injuries, \
the most mild end of the scale is someone who\'92s had a blow or jolt \
or other external force to their head which may have caused them \
to have an alteration of consciousness, \ where they might have felt like they \'91got
their bell rung\'92 \ or they may have lost consciousness altogether,
\ even for just a short period of time. \
This is the same type of concussion that athletes or youth \
might have encountered when playing contact sports \
or riding a bicycle and having an accident. \
Traumatic brain injuries are overwhelmingly treatable. \
This is especially true for concussion. \ Receiving prompt care, regardless of severity,
\ is key to returning to the highest level of
functioning possible. \ Working together, Soldiers and Family members
affected by TBI \ can be confident they\'92ll receive the world\'92s
finest treatment \ from our Department of Defense \
and Department of Veterans Affairs medical communities. \
The Defense and Veterans Brain Injury Center \
or DVBIC \ was created in 1992 by Congress because, \
at that time, \ there weren\'92t enough places throughout
the DoD and VA \ focused on head injuries. \
We wanted to combine experts on TBI and work together \
to help all the services within the Department of Defense and the VA.\
Today, we collaborate even more and have 19 sites around the world, \
working with brain injured patients from each branch of Armed Services \'96 \
Army, Navy, Air Force, and Marines, and veterans as well.\
This joint effort allows us to use the experts in every area of TBI research, \
treatment, and care so we can offer the best and most up to date care \
and technology to our wounded warriors.\ Hi, my name is Rock Cartwright. \
I've had numerous experiences with mild TBI. \
The one that I mainly remember was against the New York Giants. \
I took a hit.\ That was your first time you had a concussion?\
Yeah, that was my first time.\ I mean what happened when you had the concussion?\
Man, it was just like I just got hit on kickoff return. \
And all I can remember is -- \ you know how when you hit a bell and it vibrates?
\ That's what my brain was doin'. \
Just vibrating, just shakin'. \ And shakin' for, I don't know, \
for 10, 15 minutes it took me to get back to my normal self. \
You know how it is when you go to the sidelines, \
where your eyes are rollin' in the back of your head things like that?\
You know, my teammates would ask me, "was I okay? "was I okay?" \
and for ten minutes there, I wasn't okay. \
And then they were askin' me \'93when was my birthday,\'94 \
\'93where was I born,\'94 \'93what day it was,\'94 \'93who were we playin',\'94 \
\'93what state were we in,\'94 \'93what was my daughter's name,\'94 \
\'93what was my parents' name,\'94 \'93where did I live.\'94 \
All type of questions, just basic questions that you should always know. \
They should be able to come right off the top of your head. \
So it was an experience I\'92ll never forget. \
And I remember, days after, I still had headaches, \
still had pain in the back of my neck. \ But I\'92m doin' pretty good, right now. \
I don't have anymore effects from it.\ I know we're kinda talkin' to the soldiers
out there. \ You know a lot of times, we wanna be those
tough guys. \ Like, you say you went back in. \
And I'm sure, under any other circumstances, \
that a regular person probably wouldn't be able to do \
any type of activity. \ Let alone, go back out there and play.\
So I\'92m sayin\'92, what could you tell the soldiers out there, \
in reference to the decisions and you know how should they go about it, o\
nce they get a type of concussion? They wanna be that tough guy.\
Well I think personally, some of the side effects that you mentioned: \
some dizziness, you felt like you heard a bell. \
Just like being a soldier. \ If you're in a situation where you're not
actually where the bombing happened, \ but have some of the aftereffects of the hearing,
\ you should get it checked out. \
Because at the end of the day,\ you don't wanna come back to the states \
and have those symptoms, such as dizziness, headaches. \
Don't be so macho and take away from the consideration of your health, \
which is the most important thing.\ Just get it checked out!\
As leaders and fellow Soldiers, \ we must be vigilant against attitudes or efforts
\ minimizing the presence of concussive injury
symptoms \ of a potentially wounded Soldier. \
To maintain the fighting force we need an open climate \
for assessment, identification, proper observation, \
and rest to facilitate rapid return to duty. \
This is particularly vital after a blast event. \
The following four events require mandatory medical evaluation \
and reporting of exposure of all involved personnel. \
One, anyone in a vehicle associated with a blast event, collision, or rollover. \
Two, anyone within 50 meters of a blast \ either inside or outside a building or vehicle.
\ Three, anyone who sustains a direct blow to
the head \ or experienced a loss of consciousness. \
And four, command-directed, \ which includes but is not limited to Soldiers
with repeated exposures \ or leader observations of a soldier\'92s abnormal
behavior.\ A 24-hour rest period is mandated for all
personnel \ involved in one of these four events. \
The 24-hour rest period begins at the time of the event. \
Commanders may determine that mission requirements \
supersede individual service member welfare in certain circumstances \
but this decision is determined at the commander\'92s discretion. \
Each waiver will be documented in the required monthly report\
to the Joint Trauma Analysis and Prevention of Injury in Combat Program (JTAPIC).\
Each of these four events represents the general foundation \
of our medical evaluation process. \ The size or magnitude of a concussive event
could greatly \ expand the parameters. \
Vigilance by every Soldier in reporting any of the following symptoms \
of an injury during the first 24 to 48 hours is critical: \
Headaches, vomiting, \ ears ringing, hearing loss, \
amnesia, altered consciousness, \ loss of consciousness, double vision, \
dizziness, sleep issues, \ or something feeling wrong or something that
is not right.\ If any of these symptoms are seen, felt or
experienced, \ then Soldiers should be evaluated or re-evaluated
by medical personnel. \ The acronym HEADS will help you remember this.
\ H for headaches or vomiting, \
E for ears ringing, \ A for amnesia or altered or loss of consciousness,
\ D for double vision or dizziness, \
and S for something feeling wrong or something that is not right.\
Properly executed, \ this process will quickly identify Soldiers
with a concussion \ and ultimately return them to the fight.\
We\'92ve made great strides in equipping our Soldiers; \
one such example is the M-RAP. \ Our Soldiers are resilient. \
They may be traveling along a roadway in theater in an MRAP\
and strike an IED and many times emerge from the damaged MRAP \
with no visible injuries.\ However, they may have experienced a concussive
event, \ so it\'92s important that they be medically
evaluated prior to returning to duty. \ I cannot stress enough the importance of getting
checked out. \ No matter how well you think you were protected
\ by your personal protective equipment or your
vehicle, \ be sure to get checked out if any of the mandatory
criteria apply \ or if you meet the protocol or if something
just doesn\'92t seem right.\ Me as a player rep on the team, \
I make sure that if there is a guy that has a concussion, \
that he goes through the proper steps, the right protocol, \
to be able to go and get himself checked out.\ Because these guys have families. \
They have lives to live.\ So, I just wanna say to you guys, \
you guys are goin' through the same things. \
You may have had a concussion, \ but you may not even know it.\
So, the most important thing is, \ what is it gonna hurt, if you get it checked
out? \ If there is nothing wrong, then fine, \
You can go continue doin' what you were doin'. \
But you have to be accountable, to your fellow soldier \
to make sure that he gets the proper help.\ Unit leaders must be acutely aware of those
individuals \ who have had repeated exposure to concussive
events \ over the course of a deployment. \
Commanders and staff at all levels should track and consider \
the operational tempo and actions of these Soldiers exposed to multiple \
or repeated concussive events. \ Commanders and unit leaders should consider
\ periodic evaluation of these personnel to
ensure \ that accumulated minor concussive events do
not give rise \ to acute health-related problems. \
Examples of personnel potentially exposed to multiple \
or repeated concussive events include but are not limited to \
Route Clearance Teams, EOD Personnel, \ Weapons Intelligence Teams and Counter-IED
Team Members.\ Recurrent concussions will be closely monitored
\ and require a longer mandatory recovery period
\ than the initial concussive event \
depending on the number of incidents. \ Stricter restrictions will be placed on those
Soldiers for their protection.\ Where do you think you\'92re going?\
Wrangle up some Marines, Doc.\ I don\'92t think so! You had two mTBI incidents
in the last two weeks. \ You\'92re restricted till fine, for a week.
\ After that, the Battalion docs have to clear
you for duty, understand?\ If two documented concussions have occurred
within the past 12 months, \ return to duty is delayed for an additional
7 days following symptom resolution.\ The symptoms are hard to spot, often shrugged
off as a headache or being tired. \ Fact is, these are the tell tale signs of
mTBI. \ If three or more documented concussions have
occurred within the past 12 months,\ return to duty is delayed until a recurrent
concussion evaluation \ has been completed and a plan of care established.
\ All sports and other activities with risk
of concussion are prohibited \ until the Soldier is cleared. \
Commanders may impose more stringent requirements \
based on mission requirements and after consultation with medical personnel.\
The prevention and mitigation of potential concussion is a leadership issue. \
Leaders must enforce use of protective equipment \
and encourage Soldiers to seek evaluation if they think\
they may have sustained a concussion. \ Your support demonstrates strong leadership,
\ lessens the stigma of seeking care for this
common injury, \ and contributes to maintaining the fighting
force. \ This support needs to permeate the entire
organization \ from the senior leaders to the first line
supervisors.\ Leaders at all levels must ensure \
that Soldiers suspected of possible concussion are provided \
the maximum opportunity to receive medical evaluation and treatment \
to ensure rapid recovery and return to duty.\ Be sure you lead by example and take care
of yourself as well. \ Let me emphasize this point again. \
We are trying to change our Army culture here. \
It is not \'93weak\'94 to get out or stay out of the fight when you\'92ve had a concussion
\'96 \ you\'92ll be helping your teammates and yourself.\
The Department of Defense is at the forefront of TBI research. \
The United States Army Medical Research and Materiel Command \
leads the way with comprehensive blast injury research. \
The purpose of the Blast Injury Research Program \
is to coordinate and manage relevant DoD research efforts and programs \
for the prevention, mitigation, and treatment of blast injuries.\
The Program takes full advantage of the body of knowledge and expertise \
that resides both within and outside of the Dept of Defense \
by leveraging new civilian and other federal blast research partnerships \
with DoD medical research laboratories. \ These achieve a cutting-edge approach to solving
blast injury problems. \ In full partnership with the Department of
Veterans Affairs, \ the Defense Center of Excellence for Psychological
Health \ and Traumatic Brain Injury, \
and civilian institutions - \ ranging from major hospitals to the National
Football League\'96 \ the Dept of Defense is committed to rapidly
increasing our understanding \ of Traumatic Brain Injury and improving our
ability to diagnose, \ to treat and to care for those affected.\
All I can basically tell you men and women, again, \
from the bottom of my heart, \ from all three of us -- \
we really appreciate what you do, not only for us, but for the whole world. \
And, you have the utmost respect from me \ and I\'92m sure from Renaldo and Demetric.
\ Just get it checked out. That might as well
be our motto.\ Get checked out!\
In coming forward to change the culture\'85 \
to move forward in science and technology\'85 \
and working together as a team -- \ for those TO whom we owe so much, our warriors
and their loved ones, \ there simply is no greater privilege.}