Prehospital assessment and care

Multidisciplinary, modern prehospital and critical care has resulted in dramatic reductions in morbidity and mortality after severe traumatic brain injury (TBI) seen since the second world war. The majority of TBI fall within the mild spectrum, though mild TBI is associated with substantial costs related to lost work, neuropsychiatric complications, and disability. Since Operation Enduring Freedom and Operation Iraqi Freedom in the early 2000s, both public health and health care groups in the United States have noticed increased rates of TBI in active duty military persons. In addition to the battlefield, the sports arena is another venue in which rapid evaluation of TBI is critical. Blood pressure is thought to play a critical role in secondary injury after TBI. Patients with severe TBI should be transported to a hospital with a CT scanner, the ability to monitor intracranial pressure, ability to treat intracranial hypertension, and the ability to provide neurosurgical care.