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Running head: TRAUMATIC BRAIN INJURY 1Tara GarofaloPathopharmacological Foundations for Advanced Nursing PracticeWestern Governors University
Running head: TRAUMATIC BRAIN INJURY 2Traumatic Brain InjuryThis paper will discuss the prevalence of traumatic brain injury (TBI), globally. Includedwill be the pathophysiology, suggested standards of care, pharmacologic therapies, and disease management. International and national disparities are discussed along with the financial and economic impact that a TBI can have. And to conclude best practice guidelines, implementation of those guidelines and evaluation will be addressed.Investigated Disease ProcessGlobally today, traumatic brain injury is one of the most common causes of hospital admission and the leading cause of death. Head injuries and consequent traumatic brain injury (TBI) are a leading cause of death in Westernized society and account for one quarter to one-third of all traumatic deaths (Al-Sarraj, 2016). Brain trauma can range from mild to severe, depending on the type of injury that occurred. It can result from a small bump, jolt, blow, or from a penetrating injury. Falls are the leading cause of TBI in adults over 65 years and older; they account for 81% of TBI-related ED visits. The most common causes of TBI hospitalizations are from falls (52%) and motor vehicle collision (20%) (Lizzo & Waseem, 2020). Per Lizzo & Waseem (2020), brain trauma is significantly higher in males (78.8%) than females (21.2%). They also state that there are approximately 235,000 hospitalizations due to brain trauma, and the mortality rate is 30/100,000, about 50,000 deaths a year (Lizzo & Waseem,2020).TBI does not only affect the United States; it has impacted people globally and is known as the silent epidemic. MTBI is extremely common. An estimated that 100 to 300 per 100,000 people seek medical attention for MTBI annually worldwide.Many people with MTBI may not seek medical attention;the true global population incidence likely exceeds 600 per 100,000
Running head: TRAUMATIC BRAIN INJURY 3people annually (or roughly 42 million people worldwide every year), with most cases being due to falls or motor vehicle collisions (Gardner & Yaffe, 2015). PathophysiologyThere are primary and secondary effects on brain trauma. Per Lizzo & Waseem (2020),direct insult occurs due to the initial injury and may result in contusions, intracranial hemorrhage, and diffuse axonal injury. There may be no visible injury on imaging, and imaging may not be indicated to assess the direct damage. Traumatic intracranial hemorrhages are another type of primary trauma. Per Dixon (2017), when the brain hits against the skull, any rotational development of the brain may stretch, and now then tear, axons within the white mattertracts of the brain, which is known as “diffuse axonal injury.”Secondary effects on brain trauma include systemic and intracranial impacts that follow the initial injury. Survival of severe brain injury is dependent on avoiding or minimizing the secondary insults to the brain. Results from an older article state that systemic effects include: