Discharge Instructions for Concussion: Are We Meeting the Patient Needs?

Education to improve symptom management is an agreed-upon strategy to reduce the impact of symptoms on the quality of life for persons with mild traumatic brain injury. The purpose of this study was to investigate whether current discharge education practices are deemed adequate by persons treated and released from the emergency department with concussion. A review of current literature identified a need for patient education improvements in emergency departments.

Sedation and Analgesia in Transportation of Acutely and Critically Ill Patients.

Transportation of acutely or critically ill patients is a challenge for health care providers. Among the difficulties that providers face is the balance between adequate sedation and analgesia for the transportation event and maintaining acceptable respiratory and physiologic parameters of the patient. This article describes common challenges in providing sedation and analgesia during various phases of transport.

Considerations for neuroprotection in the traumatic brain injury population.

Traumatic brain injury can occur very quickly, but the sequelae of the injury can be life ending or life altering. Aside from prevention, the primary injury cannot be controlled; however, health care workers can influence the amount of secondary injury to the brain. This article describes potential neuroprotective methods, such as cooling, craniectomy, and medications, to help to save the brain.

Falls in the neurologic illness population.

Falls among hospital inpatients are a primary concern for all associated health care providers. Falls can result in injury to the patient and sometimes to caregivers, as well as increase health care costs through management of those injuries and potential for increased length of stay. Despite the use of fall risk assessments and fall-prevention techniques, patients continue to fall.

Symptoms associated with mild traumatic brain injury/concussion: the role of bother.

Traumatic brain injury (TBI) affects 1.4 million Americans annually, and mild TBI (MTBI) accounts for approximately 75% of those injured. For those with mild injury who seek treatment in an emergency department, there is inconsistency in the management and follow-up recommendations.

Lack of association between decompressive craniectomy and conversion to donor status.

There has been a recent resurgence in the use of decompressive craniectomy (DC) following severe brain injury. The aim of this study was to evaluate any association between DC and solid organ donation. We performed a retrospective, single-center, cohort study involving referrals to the local organ procurement organization, excluding those with anoxic brain injury.

Evaluation of moderate traumatic brain injury.

Introduction: Traumatic brain injury (TBI) affects nearly 1.4 million Americans annually with an estimated 5.3 million US citizens living with disability.

Continuous renal replacement therapy for refractory intracranial hypertension?

Background: Continuous renal replacement therapy (CRRT) is the preferred mode of renal replacement therapy in patients with acute brain injury (ABI). There are limited data available describing the effects of CRRT on intracranial pressure (ICP). This study aims to evaluate changes in ICP during CRRT in patients after ABI.

Fluid balance, complications, and brain tissue oxygen tension monitoring following severe traumatic brain injury.

Background: Refractory intracranial hypertension (RIH) frequently complicates severe traumatic brain injury (TBI) and is associated with worse outcomes. Aggressive fluid resuscitation contributes to the development of peripheral and pulmonary edema, but an effect on cerebral edema is not well established. Some clinicians, including advocates of the "Lund Concept", practice fluid restriction as a means of limiting cerebral edema and reducing intracranial pressure (ICP).

Continuous renal replacement therapy for refractory intracranial hypertension.

Introduction: Little is known about the effects of hemodialysis on the injured brain, however; concern exists over the use of intermittent hemodialysis in patients with acute brain injury (ABI) due to its hemodynamic effects and increased intracranial pressure (ICP) associated with therapy. Continuous renal replacement therapy (CRRT) has become the preferred method of renal support in these patients though there is limited data to support its safety. Furthermore, exacerbations of cerebral edema have been reported.

Symptom experience and emotional distress after traumatic brain injury.

Traumatic brain injury (TBI) is unexpected and affects nearly 1.5 million Americans annually. Many with seemingly minor injuries incur long-lasting symptoms without clear explanation.