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 Post subject: Mild Traumatic Brain Injury (mTBI) and long term care
PostPosted: Sat May 18, 2013 5:45 pm 
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Dr. Roderick Bain wrote:
You may have noticed in ”Letters” of a recent ARMY 9 May news regarding PTSD and its importance in post-MEAO conflicts. There is yet another confusing additive to this mix of which you’re possibly well aware and it needs further exploration I believe. This is wonderfully illustrated in the enclosed US. “Sixty minutes” program on mTBI.

There is a rapidly growing need to move beyond the ADF Health Directive 293, 'Management of mTBI' and proceed now to the next step which for the sufferers and carers is currently unclear. We need in conjunction with the DVA , Sports Medicine Australia and other specialist groups to establish a civilian protocol to which veterans and their families can refer when considering the significance of symptoms they possess or believe are associated with an incident of concussion once they are out of the ADF. For them to resort to the internet for assistance would be a most unsatisfactory and confusing outcome.

A number of us worked with great dilligence to have these entitlements acknowledged through the Statements of Principles (SOPs) developed last September by the Repat. Medical Authority. This was done in conjunction with Professors Nicholas Saunders and Ken Donald as well as Major General Jeff Rosenfeld.

5 September 2012

At the meeting of 7 & 8 August 2012 the RMA

Determined Statements of Principles (SoPs) for:

physical injury due to munitions discharge…......48/2012 & 49/201

These SoPs revoke the SoPs previously determined for these conditions

Determined SoPs for:

moderate to severe traumatic brain injury…..……62/2012 & 63/2012
concussion………………………………............…64/2012 & 65/2012
Now these principles are in place to pursue MRCA/VEA entitlements there remains one further step to be achieved.

Having suffered from a fractured skull myself during my specialist registrar training years I’m only too aware of the need for direction regarding symptomatology and the need to allay anxieties that will inevitably arise.

Apart from Sports Medicine Physicians, general practitioners in the medical world are ill equipped to deal with these cases as I’ve already discovered with young ex-service males on more than one occasion.

In conjunction with ex-service groups and the Department of Veterans’ Affairs I would like to see suitably worded guide lines made available to ex-service organisations' welfare officers and general practioners throughout this country. The need currently exists and will become more urgent as personnel continue to leave the ADF over time.

There already exists mechanisms for rapid distribution to both parties. The remaining hurdle is the composition of the material. Please find attached the most recent Consensus Statement on Concussion released by the British Journal of Sports Medicine May 2013. I belive we would do well to commence our deliberations from here although there are additional factors when involving an ADF member.

What I need is assistance from people with a concussion experience to collect further cases from your clients and readers for me to encourage DVA to proceed rapidly with this project. Individuals do not need to be identified but I do need their symptoms and difficulties along with a history to underline the problem. Currently I have some excellent cases but I would like at least a dozen to seal the argument in order to proceed. My contact is below. Any publicity you can provide for this effort would be appreciated. The publication of this letter (or abbreviated) would be perfect.

Thank you for your assistance in the matter.

Best regards,


Dr. Roderick Bain FRCA, FANZCA RAN (Rtd)
Medical Adviser RSL National Executive
Tel 0417823937

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