PTA

Age 8 or up:

• Mild TBI (GCS 13-15 at scene): A-WPTAS
  • Pass within 24 hours - 'out of PTA'
  • Fail after 4 hours - go on to WPTAS
  • Not administered within 24 hours - needs daily PTA
• Mod TBI (GCS 9-12 at scene): WPTAS 1-7 days
• Severe TBI (GCS 8 or less): WPTAS > 7 days

Age 4-7:

• Sydney Post-Traumatic Amnesia Scale (SYPTAS) - needs 5/5 on 3 consecutive days to be cleared

Age 0-3:

• No PTA available
• OT or neuropsych should do play/activity based assessment, management and discharge planning

General PTA principles

• Only start once patient can demonstrate a consistent yes/no response
• Out of PTA once patient gets 12/12 on WPTAS or 5/5 on SYPTAS on 3 consecutive days
• Clinical judgement CAN be used to stop early
• No prompts or hints
• Child shouldn't be able to see calendar/clock
• If patient states 'I don't know', repeat question and give 3 consecutive options

Administration

• Day 1:
  • 7 orientation questions, and show the 5 memory items (name/face and 3 picture cards) and practice the memory part
  • Maximum score 7/7
  • Correct any wrong answers
• Day 2:
  • Ask 7 orientation questions and 5 memory questions

A-WPTAS

• Hourly trials for 4 hours
• Total score out of 18
• Out of PTA when they obtain 18/18

1. What is your name?
2. What is the name of this place?
3. Why are you here?
4. What month are we in?
5. What year are we in?
6. Show the three picture cards for 10 seconds and ask the patient to name them.

QPTAS:

Orientation part:

1. How old are you?
2. What is your date of birth?
3. What month are we on?
4. What time of day is it? Morning, afternoon or night?
5. What day of the week is it?
6. What year are we in?
7. What is the name of this place? (Needs to give specific hospital)

Memory part:

1. Have you seen my face before?
2. What is my name? (Can give 3 options all starting with same letter - Simon, Samuel, Steven
3. What were the three picture cards I showed you yesterday?