Improvised explosive devices are the weapons of choice for the insurgent enemy in Iraq and Afghanistan. More soldiers are surviving these blast injuries due to improved torso protection yet are sustaining head and neck wounds in numbers that exceed those from previous wars. Although moderate and severe traumatic head injuries are easily identified and aggressively treated, mild traumatic brain injuries (m-TBIs), or concussions, had previously been deemed inconsequential and often overlooked. Recently, however, the U.S. Department of Defense and Veterans Health Administration have placed emphasis on identifying service members at risk for m-TBI because a select number continue to have disabling symptoms that can negatively affect quality of life. Research regarding the effects and treatment of blast injury are gaining momentum, but further work needs to be accomplished. This article provides a three-question screening tool that can be used to identify these at-risk veterans.

1 PTSD has been an under-diagnosed syndrome among World War II and Korean era veterans both because of clinical inattention and the way this generation of soldiers coped with traumatic memories throughout their lives. 2 There are psychological, developmental, and situational factors that may cause PTSD symptoms to resurface among older veterans in health care settings. 3 Nurses in health care settings who have frequent contact with the elderly are in a unique position to identify older veterans who might be at risk for resurfacing of PTSD symptoms and to provide limited assistance and referral for mental health treatment.

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