Abbreviated Westmead for GCS and PTA Testing of TBI

Use of A-WPTAS and GCS for patients with MTBI
The A-WPTAS combined with a standardized GCS assessment is an objective measure of post traumatic amnesia (PTA).

Only for patients with current GCS of 13-15 (<24hrs post injury) with impact to the head resulting in confusion, disorientation, anterograde or retrograde amnesia, or brief LOC. Administer both tests at hourly intervals to gauge patient’s capacity for full orientation and ability to retain new information. Also, note the following: poor motivation, depression, pre-morbid intellectual handicap or possible medication, drug or alcohol effects. NB: This is a screening device, so exercise clinical judgement. In cases where doubt exists, more thorough assessment may be necessary.

Admission and Discharge Criteria:

• A patient is considered to be out of PTA when they score 18/18.
• Both the GCS and A-WPTAS should be used in conjunction with clinical judgement.
• Patients scoring 18/18 can be considered for discharge.
• For patients who do not obtain 18/18 re-assess after a further hour.
• Patients with persistent score <18/18 at 4 hours post time of injury should be considered for admission.
• Clinical judgement and consideration of pre-existing conditions should be used where the memory component of A-WPTAS is abnormal but the GCS is normal (15/15).
• Referral to GP on discharge if abnormal PTA was present, provide patient advice sheet.