Acute treatment of a Traumatic Brain Injury (TBI) initiates several metabolic processes that can aggravate the injury, therefore, management focuses on stabilizing and preventing a secondary injury. Ultimately, the goal is to assess and stabilize the airway and circulation, maintain adequate blood and oxygen supply to the brain, stop intracranial bleeding and prevent an increase in pressure within the skull. However, full neuro-monitoring including intracranial pressure measurement are rarely available prior to the patient’s arrival to the intensive care unit. Mechanical intervention (ventilation support) assists in breathing while alleviating pressure on the brain.
Traumatic brain injury (TBI) is a major health and socioeconomic problem that affects all societies. Research shows that worldwide, TBI is a leading cause of death and permanent disability. In the United States alone there are approximately 1.4 million reported cases of TBI each year. Unfortunately, there is difficulty in recording the real incidence of TBI 's since many patients refuse to report the incident and seek medical care.
Half of those who die from TBI do so within the first two hours of injury it is now known, however, that all neurological damage does not occur at the moment of impact (primary injury) but rather evolves over the ensuing minutes, hours or days. This secondary brain injury can result in increased mortality and disability. Consequently the early and appropriate management of TBI is critical to the survival of these patients.
Emergency Medical Services (EMS) personnel are often the first healthcare providers for patients with TBI. Thus, prehospital assessment and treatment is a critical link in providing appropriat...
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...craniotomy may be done to open the skull if there have been fractures in the bone, large blood clots or swollen brain tissue. Smaller blood clots will be removed to help relieve pressure or to place an intracranial pressure monitor. A bone flap removal is when a piece of bone is removed from the skull to make room and relieve pressure that is caused by swollen brain tissue.
Once patients are stabilized in the acute setting they will be transferred to a subacute dramatic brain injury treatment center where their rehabilitation will be initiated. At the specialized care facilities medical staff will fully evaluate the patient 's impairments, disabilities and probability of recovery. Doctors will also outline a course of treatment and health patients and their families build the right team of medical professionals necessary for successful rehabilitation.
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