A soldier showing certain clinical findings may have potentially serious battle fatigue (battle reaction) that requires significant intervention. Some but not all soldiers with these findings may need to be evacuated as a casualty.
General criteria for potentially serious battle fatigue:
(1) significant symptom that persists after a good rest
(2) associated with significant personality change
(3) significant symptom that disrupts a mission (no longer functioning)
Physical findings:
(1) constantly moving, unable to sit still
(2) flinching or ducking at slightest sound or movement
(3) shaking uncontrollably
(4) cowering in terror
(5) cannot move a body part (hand, arm, leg) with no physical reason
(6) cannot see or hear with no physical reason
(7) freezing into immobility when under fire
(8) physical exhaustion that cannot be explained
(9) "spaced out" with vacant stare
(10) staggering and swaying while standing
Psychological findings:
(1) rapid, constant talking, or mute
(2) arguing, starting fights
(3) reckless action and indifference to danger
(4) inattention to self-care and hygiene
(5) memory loss
(6) disorientation to time and/or place
(7) severe stuttering or muttering or talking to self
(8) afraid to fall asleep
(9) unable to stay asleep
(10) seeing or hearing things that are not there
(11) rapid emotional shifts
(12) social withdrawal
(13) prolonged sadness
(14) apathetic
(15) not eating at all
(16) hysterical outbursts or crying spells
(17) strange, bizarre behavior
(18) panic, running away when under fire
Differential diagnosis:
(1) heat exhaustion
(2) malaria or other infectious disease
(3) post-concussion
(4) internal injury
