Combat & Casualty Care

Q2 2016

Military Magazines in the United States and Canada, Covering Combat and Casualty Care, first responders, rescue and medical products programs and news\Tactical Defense Media

Issue link:

Contents of this Issue


Page 5 of 39 4 | Combat & Casualty Care | Summer 2016 Medical Advances Traumatic Brain Injury The U.S. Defense and Veterans Brain Injury Center (DVBIC) is a one of a kind DoD installation addressing active duty and veterans needs for mild traumatic and post traumatic brain injuries. By Terry L. Welch, Senior Communications Manager, DVBIC I t was a training exercise that caused Sgt. Miller's traumatic brain injury (TBI). A ground-level gust, a large rock underfoot and awkward fall led to his head bouncing off the ground during a unit parachute training jump. A nearby soldier noticed the sergeant moving a bit sluggishly and asked if he was OK and Sgt. Miller said he felt a bit dizzy. Prevention U.S. Army Sgt. James Miller is 24 and served his country for five years as an airborne infantry soldier. Before Sgt. Miller was injured, he knew a little something about protecting himself from TBIs. His company commander invited the local Defense and Veterans Brain Injury Center (DVBIC) regional education coordinator (REC), Jessica Conrad, to talk to the company about TBI. Jessica explained that he and his soldiers were far more likely to sustain a TBI at home than while deployed. She told them that, if they did get a TBI, it would probably be a mild TBI, also known as a concussion. "In fact," she said, "of the more than 340,000 service members who've sustained a TBI since 2000, more than 82 percent were mild." Jessica said that most of those with concussions recovered fully within a few weeks, with no lingering symptoms or problems. She added that identifying and seeking treatment as soon as possible provides the most promise for positive outcomes and handed out fact sheets from A Head for the Future, a Defense Department public awareness initiative led by DVBIC. "One of DVBIC's main missions is educating service members, veterans and their families about the prevention, recognition and treatment of TBI," said Scott Livingston, DVBIC Education director. "We want to prevent as many TBIs as possible, so we provide tools for individuals, practitioners and leaders." Treatment Before 2010, it was up to Sgt. Miller to report his symptoms. But during that year, the Defense Department, following DVBIC recommendations, implemented an incident-based reporting protocol. Instead of relying on a service member to self-report—an action some were unwilling to take—incidents like this hard fall (or proximity to blasts, vehicle accidents, etc.) require those involved to be checked for concussion. Sgt. Miller's fellow soldier alerted the unit medic, who reached into his pocket and pulled out the "Military Acute Concussion Evaluation (MACE)" pocket guide. DVBIC developed the guide (with service input) as an initial screening tool after a potentially-concussive event. Sgt. Miller struggled slightly on a test of his immediate memory and while saying the months of the year in reverse order, so the medic sent him to the base hospital for further examination. At the hospital, Sgt. Miller saw an Army doctor very familiar with DVBIC. The doctor's shelf held clinical recommendations created by the center with input from representatives of the Defense Department TBI Advisory Committee. She attended webinars and the DVBIC annual TBI summit to learn about the latest research, and downloaded research reviews on TBI topics. In short, she felt entirely up-to-speed on the latest clinical practices. "DVBIC is really attempting to standardize practices for TBI throughout the DoD," said Katie Stout, DVBIC Clinical Affairs director. "We want to make sure state-of-the-science research is being translated to the consistent, quality treatment for TBI." While there are common symptoms, how a TBI affects each individual is as varied as individuals themselves. Sgt. Miller felt "woozy" during that first visit, but by the second (a day later), he only had a headache. When the headaches lasted beyond the first week, Sgt. Miller's doctor reviewed the DVBIC clinical recommendation for treating post-concussion headaches. Created with input from service representatives and experts in the Defense Department, Department of Veterans Affairs and civilian practice, DVBIC clinical recommendations offer medical providers guidance on treatment options, algorithms to help diagnose/ manage symptoms, and referrals to specialists. These tools also include handouts for patients to help keep them in the loop about TARGETING CONCUSSION, MINIMIZING EFFECT (DVBIC)

Articles in this issue

Links on this page

Archives of this issue

view archives of Combat & Casualty Care - Q2 2016