PURPOSE To provide student nurses with an understanding of the treatment of service members with severe traumatic brain injury (TBI). OBJECTIVES After reading the article and taking the test, you will be able to: Identify the mechanisms of injury and classification of TBIs. Describe the levels of acute care and the rehabilitation for a service member with a TBI.
Nature of the external force
Motivation of the patient
Strength of the force
Coup or coup-contra-coup
A depressed skull fracture.
Foreign matter disrupting the dura.
Increased intracranial pressure.
A linear skull fracture.
Gunshot wounds to the head or neck
Motor vehicle accidents
Direct exposure to the overpressurization wave of the explosion
Inhalation of gases or other toxic substances
The body is displaced and impacts another object
Energized debris or explosive fragments impact the head
Glasgow Coma Scale (GCS) score of 13 to 15
Loss of consciousness/alteration of consciousness between 1 and 24 hours
Posttraumatic amnesia >7 days
GCS score of 3 to 8
All of the above
Prognosis of a severe TBI.
Complicated mild TBI.
Simple severe TBI.
Functional status at 12 months.
Progress more than 6 months.
Severity of the initial injury.
Rate of recovery.
Cover fire and evacuation to a safe zone
Documentation of mental status
Prevention of hypoxia and hypothermia
Aggressive intracranial pressure therapy
Emergent neurosurgical care
Field management of a TBI
Long-term intensive care
Presence of a physician on board
Shorter flight time
Lower flight altitude
Long-term functional outcome.
Purposeful and appropriate response.
Secure records transfers
Through Department of Veterans Affairs social workers
Here's an interesting quiz for you.