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Traumatic Brain Injury Program
Traumatic head or brain injury is an increasing problem in the United States because of the number of survivors who suffer long term consequences and families who struggle to return their lives to normal as much as possible. The injury results from trauma such as an object striking the head or the head striking an object, and/or rapid acceleration and deceleration of the brain inside the skull as during a car crash. Injuries may be open (such as a gunshot wound) or closed (brain is injured although the skull is intact). Compression and twisting of the brain inside the skull, with an impact or violent movement, may cause local or widespread physical damage throughout the brain. The main causes of traumatic brain injury are motor vehicle crashes, falls, gunshot injuries, assaults, sports, and pedestrian injuries.
Many survivors have short- or long-term limitations or disabilities such as thinking or decision-making problems, hearing/vision/speech deficits, physical limitations, or behavior problems. Survivors may need rehabilitation or community-based services to improve mobility, self-care, and job skills; however, needed services may not be available in their area or survivors may not have the resources to pay for them.
Unless there are neurologic complications, the severity of most deficits and problems will improve substantially within the first year after the injury when the most biologic improvement occurs. People can continue to improve and experience positive changes years after their original injury. The main factor affecting school, work, and daily living, however, is severity of the injury.
Phases of Prevention and Care
The first phase is prevention which includes the use of protective equipment (such as seat belts and helmets) and using safety precautions appropriate to the activity being performed (such as grasping a hand rail on stairs or using care while walking) to prevent falls. Even though not every injury can be prevented, use of protective equipment and safety habits can often keep the injury from being as severe.
The second phase is emergency medical treatment where initial life-saving care is given during ambulance transport to an appropriate hospital emergency room where definitive life-saving and diagnostic procedures are provided.
The third phase is all hospital inpatient services that have the goal to save the person's life or stabilize his or her medical condition. Services may include intensive care, acute care, and establishing need for rehabilitation or other specialized services.
The fourth phase is inpatient rehabilitation. The goal of rehabilitation is to restore the patient to an optimal level of physical, cognitive and behavioral status so the individual may return to the home, school, or employment and function as close to a pre-injury level as possible. Rehabilitation includes physical, occupational, swallowing, and speech/language therapies, as well as counseling, neuropsychologic testing, and physiatrist/neurologist/case management services, depending on the patient's needs. Inpatient rehabilitation may not be needed in every case.
The fifth phase involves services available in the community that are usually provided over time and include outpatient rehabilitation, vocational rehabilitation and employment counseling, special education services, personal care assistance, independent living assistance, support groups, or other basic health services. These services may not be available in all areas of the state or to all survivors because of the lack of qualified personnel or financial resources.
Injury Prevention Service
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