Brain Trauma Foundation
Brain Trauma Foundation (BTF) was founded in 1986 to develop research on Traumatic Brain Injury (TBI). Since it's formation the foundation's mission has expanded to improving the outcome of TBI patients nationwide through working to implement evidence-based guidlines for prehospital and in-hospital care, quality-improvement programs, and coordinating educational programs for medical professionals.
TBI Guidelines
The Brain Trauma Foundation has developed the Guidelines for the Management of Severe Traumatic Brain Injury and the companion guidelines for pediatric TBI, prehospital management of TBI, early indicators and prognosis of severe TBI, surgical management of TBI and field management for combat medics. The Guidelines for management of the management of severe TBI, first published in 1995 and revised twice most recently in 2007, seek to create uniformity in TBI care all over the world.[1]
An independent analysis of the effect of the Brain Trauma Foundation’s (BTF) guidelines on traumatic brain injury (TBI) outcome and cost savings by the Centers for Disease Control and Prevention (CDC) found that if the BTF guidelines were used more routinely, there would be a 50% decrease in deaths, improved quality of life and a savings of $262 million in annual medical costs, $43 million in annual rehabilitation costs and a lifetime societal cost of $3.84 billion. [2]
The Guidelines have been endorsed by the American Association of Neurologic Surgeons, the World Health Organization Neurotrauma Committee, and the New York State Department of Health. The guidelines have been distributed to all neurosurgeons in the United States. The guidelines provide medical personnel a protocol which has been proven to improve the survival and outcomes of TBI patients and has been shown to reduce rates of mortality. [3] [4] [5]
ICP Monitoring
One of the main facets of the guidelines is the recommendation to monitor intracranial pressure in treating severe TBI patients. This process is called ICP Monitoring.
When the brain suffers severe trauma it begins to swell inside the skull. If the brain swelling goes undetected and is not treated the brain becomes deprived of oxygen-rich blood and "starves". This secondary injury causes permanent brain damage. With ICP Monitoring, which tells doctors how much swelling the brain has sustained and can drain cerebrospinal fluid, which would relieve some of the pressure, this outcome can be prevented.
In the United States surveys conducted in 1995, 2000 and 2006 have shown that since 1995 (the year the TBI Guidelines were published) ICP Monitoring rose from 32% to 78% in 2005..[6].[7].[8]
Board of Directors
• Jamshid Ghajar, M.D., Ph.D., President
• Pamela Drexel, Executive Director
• Alan Quasha, Chairman
Medical Advisory Board
M. Ross Bullock, MD, PhD, Chairman Virginia Commonwealth University
Mary Kay Bader, MSN,CCRN,CNRN Mission Hospital Regional Medical Center
Robert M. Domeier, MD National Association of EMS Physicians
James Ecklund, MD, FACS Walter Reed Army Medical Center
Thomas J. Esposito, MD, MPH, FACS Loyola University
Steven R. Flanagan, MD Mount Sinai School of Medicine
Thomas A. Gennarelli, MD Medical College of Wisconsin
Ronald L. Hayes, PhD Banyan Biomakers, Inc.
E. Brooke Lerner, PhD, EMT-P Medical College of Wisconsin
Peter B. Letarte, MD, FACS Loyola University Medical Center
Harvey S. Levin, PhD Baylor College of Medicine
Andrew I.R. Maas, MD, PhD Enasmus Medical Center, Rotterdam, Netherlands
Geoffrey T. Manley, MD, PhD University of California, San Francisco
Michael Pasquale, MD Lehigh Valley Hospital
Peter T. Pons, MD, FACEP University of Colorado Health Sciences Center
Claudia Robertson, MD Baylor College of Medicine
Franco Servadei, MD M. Bufalini Hospital, Cesena, Italy
John Whyte, MD, PhD Moss Rehabilitation Research Institute
- ↑ "Guidelines for the management of severe traumatic brain injury", Journal of Neurotrauma, 24 (Supplement 1), May, 2007 Check date values in:
|publication-date=(help). - ↑ Faul, Mark; Wald, Marlena; Rutland Brown, Wesley; Sullivent, Ernest; Sattin, Richard (December), "Using a Cost-Benefit Analysis to Estimate Outcomes of a Clinical Treatment Guideline: Testing the Brain Trauma Foundation Guidelines for the Treatment of Severe Traumatic Brain Injury.", Journal of Trauma-Injury Infection & Critical Care (63(6)), pp. 1271–1278 Check date values in:
|date=, |year= / |date= mismatch(help) - ↑ Fakry, SM; Trask, AL; Waller, MA (2004), "Management of Brain-injured patients by an evidence-based medicine protocol improves outcomes and decreases hospital charges", J Trauma (56), pp. 492–499, discussion 499-500.
- ↑ Palmer, S; Qureshi, A (2001), "The impact on outcomes in a community hospital setting of using the AANS traumatic brain injury guidelines Americans Associations for Neurologic Surgeons", J Trauma (50), pp. 657-664'
- ↑ Patel, HC; Menon, DK; Tebbs, S (2002), "Specialist neurocritical care and outcome from head injury.", Intensive Care Med (28), pp. 547–553
- ↑ Ghajar, J; Hariri, RJ; Narayan, RK (1995), Crit. Care Med, 23, pp. 560–567 Missing or empty
|title=(help). - ↑ Hersdorffer, DC; Ghajar, J (2002), J Trauma, 52, pp. 1202–1209 Missing or empty
|title=(help). - ↑ Hersdorffer, DC; Ghajar, J (2007), "Marked improvement in adherence to traumatic brain injury guidelines in United States trauma centers", J Trauma, 63, pp. 841–848.