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Defense and Veterans Brain Injury Center releases new concussion screening tool

Military health care providers practice administering the MACE 2 during a two-day TBI workshop led by DVBIC at Fort Belvoir, Virginia. (Photo by Carlson Gray) Military health care providers practice administering the MACE 2 during a two-day TBI workshop led by DVBIC at Fort Belvoir, Virginia. (Photo by Carlson Gray)

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Traumatic Brain Injury

Providers who screen patients for concussion now have a new and improved tool. The latest version of the Military Acute Concussion Evaluation, known as the MACE 2, is now available. The MACE 2 is for use by all medically trained personnel who treat service members with suspected traumatic brain injury (TBI). This includes medics, corpsmen, and other health care providers.

The Defense and Veterans Brain Injury Center, the Defense Health Agency’s Research and Development Directorate’s traumatic brain injury center of excellence, developed the MACE 2 from the 2012 version of MACE. The MACE 2 combines state-of-the-science advances in concussion care and feedback from military end users. The result is a more thorough tool to evaluate and document concussions in service members and veterans.

“DVBIC developed the original MACE primarily for medics and corpsmen, who are most often the initial medical contact treating service members in the field,” said Dr. Katherine Stout, DVBIC chief of clinical affairs. “MACE 2 represents a tool for any provider treating service members with a suspected or potential TBI as close to the time of injury as possible.”

In addition to broadening the base of users, the MACE 2 includes other important updates. The most significant is the addition of the Vestibular Ocular Motor Screening (VOMS). The VOMS helps providers assess vestibular and oculomotor functions in patients with suspected concussion. Additionally, DVBIC expanded portions of the MACE 2 neurological exam to increase clarity and comprehensiveness, including speech and balance testing. The MACE 2 also includes new instructions, “Red Flags,” observable signs and symptoms, and updated questions on the patient’s injury and medical history.

DVBIC has developed training tools to support providers’ transition to MACE 2 from earlier tools. “To ensure providers are up to date on the changes in the MACE 2 it is recommended that all medics, corpsmen, and health care providers should receive MACE 2 training,” said Stout. As with the 2012 MACE, the MACE 2 remains a free concussion-screening tool intended for use by military, veteran, and civilian medical personnel and is available for order in hard copy or digital download on the DVBIC website.

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Diagnoses of Traumatic Brain Injury Not Clearly Associated with Deployment, Active Component, U.S. Armed Forces, 2001 – 2016

Infographic
4/4/2017
Traumatic Brain Injury (TBI) is structural alteration of the brain or physiological disruption of brain function caused by an external force.  TBI, particularly mild TBI or concussion, is the most common traumatic injury in the U.S. military. This analysis provides the estimated rates of incident TBIs among service members before their first-ever deployment as well as separately among service members during deployments/ after deployments. It also mentions factors that may explain why the TBI incidence rates among the previously deployed were higher than those of the never-deployed group. Moreover, it describes the demographic and military traits of service members diagnosed as TBI cases (before/after deployment). Categorization of person time during surveillance period included four categories: Group 1 (Never deployed/TBI before first-ever deployment), Group 2 (Currently deployed or within 30 days of return), Group 3 (previously deployed but not currently deployed nor within 30 days of return) and Censored after Diagnosis of TBI. From 2001-2016, 276,858 active component service members received first-time diagnoses of TBI. The crude overall incidence rate of TBI among deployed service members was 1.5 times that of service members assigned to Group 1 and 1.2 times that of service members in Group 3 during the surveillance period.  Total TBI cases by group were Group 1 42.8%, Group 2 13.2% and Group 3 44.0%. Incidence rates by group (per 100,000 person-years) were Group 1 1,141.3, Group 2 1,690.5, and Group 3 1,451.2. Learn more at www.Health.mil/MSMR and see fact sheets at www.Health.mil/AFHSB

Traumatic Brain Injury (TBI) is structural alteration of the brain or physiological disruption of brain function caused by an external force. TBI, particularly mild TBI or concussion, is the most common traumatic injury in the U.S. military. This analysis provides the estimated rates of incident TBIs among service members before their first-ever deployment as well as separately among service members during deployments/ after deployments. It also mentions factors that may explain why the TBI incidence rates among the previously deployed were higher than those of the never-deployed group. Moreover, it describes the demographic and military traits of service members diagnosed as TBI cases (before/after deployment).

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Traumatic Brain Injury | Armed Forces Health Surveillance Branch
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