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Acute clinical care and care coordination for traumatic brain injury within Department of Defense

Michael S. Jaffee, MD, et al.

Figure. Medical evacuation of battle-injured patients across three continents typically occurs within days from injury because of sophisticated trauma systems supported by robust training and educational initiatives.

The nature of current combat situations encountered by U.S. military forces has dramatically increased the risk of traumatic brain injury (TBI) in military personnel. While TBI may result in physical impairment, often the more problematic consequences involve the individual's cognition, emotional functioning, and behavior. These consequences can affect all aspects of a person's life, including the development or maintenance of interpersonal relationships and the ability to function in employment settings. This article summarizes the systems of care available for the management of TBI from point of injury to the transition to the Department of Veterans Affairs treatment facilities. We describe TBI assessment, treatment, and overall coordination of care for patients with TBI, including innovative clinical initiatives used during current conflicts. This information was drawn from multiple efforts to rapidly identify persons with TBI and provide comprehensive treatment toward recovery.


Volume 46 Number 6, 2009
   Pages 655 — 666


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