Posttraumatic Amnesia and Children's Orientation and Amnesia Test
The duration of PTA is another commonly used indicator of injury severity. There is general agreement that the duration of PTA is directly correlated with the severity of injury (56-58).
Compared with GCS, PTA has the merit of a longer period of observation. However, there is no generally accepted and easily applied method for determining the duration of PTA, especially in children. Assessments must be adapted, as appropriate, according to an individual’s age (58). The Children’s Orientation and Amnesia Test (COAT) has been helpful in evaluating length of PTA. It was designed to assess cognition serially during the early stage of recovery from TBI in children. The COAT is composed of 16 items evaluating general orientation, temporal orientation, and memory. The duration of posttraumatic amnesia is indicated by the number of days COAT scores are in the impaired range (59). Although this test should be useful in prospective outcome studies of children without profound injury, it has a major disadvantage because it takes 5 to 10 minutes to administer and, therefore, has not become a routine assessment on most clinical services. It has also been shown to be sensitive to nontraumatic impairment. For example, children receiving special education services fall within the impaired range, and the COAT, therefore, should be interpreted with caution (60).
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