Downloaded from by LhClQvh6lnnGt7/lThf7BKk7IUuJ9hrzlc5udjQIq1gtE+5o8OEWZhMcKXnWBZvWtCNcnkrOWA57OK8erurcvviOEggPgx49Sf9apZ58izD/ASKBVT1mAdug1QYsnNNyA5Gw3+/g4IA= on 03/28/2018Downloaded from by LhClQvh6lnnGt7/lThf7BKk7IUuJ9hrzlc5udjQIq1gtE+5o8OEWZhMcKXnWBZvWtCNcnkrOWA57OK8erurcvviOEggPgx49Sf9apZ58izD/ASKBVT1mAdug1QYsnNNyA5Gw3+/g4IA= on 03/28/201820lNursing2018CriticalCarelVolume 13, Number 1Recognizing and managing traumatic brain injuryTraumatic injuries can occur in an instant and have lifelong sequelae for the individual affect-ed. While traumatic injuries can occur to any part of the human body, none have as many life-altering consequences as those affecting the brain. Termed trau-matic brain injury (TBI), this type of injury affects all other physio-logic functions as well as behav-ioral, emotional, cognitive, and psychological status.DefinitionTBI results from an external force, physical or concussive (such as from a blast), which dis-rupts the structural integrity of brain tissue and cerebral vascula-ture. Consequences of TBI can include loss of consciousness, amnesia to the event, alterations in mental state (confusion, slowed thinking), or neurologic deficits (paresis, loss of balance, change in vision, and/or aphasia) imme-diately following the injury.1TBIs are classified by sever-ity, most commonly using the Glasgow Coma Scale (GCS).2A patient with a mild TBI presents with a GCS of 13 to 15, often with a brief loss of consciousness. A GCS of 9 to 12 is considered an indicator of a moderate TBI, and a GCS of 8 or less can indicate a severe TBI if other factors such as drugs and/or alcohol intoxica-tion are not a factor.3Most TBIs By Carla J. Wittenberg, MSN, ACNP-BC, RNFAAbstract:Traumatic brain injury (TBI) is the leading cause of death in North America for individuals aged 1 through 45. Healthcare costs from TBI are high, and survivors are often left with significant dis-abilities that have economic, social, and societal impacts. This article discusses TBI and its management to guide critical care nurses in understanding and caring for this complex and serious injury.Keywords: concussion, critical care, Glasgow Coma Scale, traumatic brain injuryPOSTERIORI / iSTOCKCopyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
January lNursing2018CriticalCare l21Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
22lNursing2018CriticalCarelVolume 13, Number 1Recognizing and managing traumatic brain injuryare mild and are considered con-cussions. Although sports- and recreation-related injuries often include a diagnosis of concussion, some brain injuries are moderate-to-severe in nature.
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