Volume 44 Number 7 2007
Pages 1027 — 1034
Abstract - Program development and defining characteristics of returning military in a VA Polytrauma Network Site
Henry L. Lew, MD, PhD;1-3* John H. Poole, PhD;1-3 Rodney D. Vanderploeg, PhD;4-6 Gregory L. Goodrich, PhD;1 Sharon Dekelboum, OTR/L;1 Sylvia B. Guillory, BS;1 Barbara Sigford, MD, PhD;7-8 David X. Cifu, MD9-101Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA; 2Defense and Veterans Brain Injury Center (DVBIC), Palo Alto, CA; 3Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Stanford, CA; 4DVBIC, Tampa, FL; 5James A. Haley Veterans' Hospital, Tampa, FL; 6University of South Florida, Tampa, FL; 7DVBIC, Minneapolis, MN; 8Minneapolis VA Medical Center, Minneapolis, MN; 9Hunter Holmes McGuire VA Medical Center, Richmond, VA; 10Virginia Commonwealth University, Richmond, VA
Abstract — The conflicts in Iraq and Afghanistan have resulted in a new generation of combat survivors with complex physical injuries and emotional trauma. This article reports the initial implementation of the Polytrauma Network Site (PNS) clinic, which is a key component of the Department of Veterans Affairs (VA) Polytrauma System of Care and serves military personnel returning from combat. The PNS clinic in Palo Alto, California, is described to demonstrate the VA healthcare system's evolving effort to meet the clinical needs of this population. We summarize the following features of this interdisciplinary program: (1) sequential assessment, from initial traumatic brain injury screening throughout our catchment area to evaluation by the PNS clinic team, and (2) clinical evaluation results for the first 62 clinic patients. In summary, this population shows a high prevalence of postconcussion symptoms, posttraumatic stress, poor cognitive performance, head and back pain, auditory and visual symptoms, and problems with dizziness or balance. An anonymous patient feedback survey, which we used to fine-tune the clinic process, reflected high satisfaction with this new program. We hope that the lessons learned at one site will enhance the identification and treatment of veterans with polytrauma across the country.
Key words: brain concussion, brain injuries, hearing disorders, needs assessment, neuropsychology, pain, physical medicine, posttraumatic, rehabilitation, stress disorders, vision disorders.