title: A survey of mild traumatic brain injury treatment in the emergency room and primary care medical clinics.
abstract: This study surveyed health care providers about their evaluation and treatment of mild traumatic brain injury (TBI) in adults. We presented two vignettes describing mild TBI cases to staff in the emergency department (N = 22) and primary care clinics (N = 16) at Wilford Hall Air Force Medical Center and asked how they would evaluate and treat these patients. Most providers said they would assess visual changes, nausea/vomiting, headache, and neck pain. More emergency department personnel than primary care clinic providers would make referrals to different specialties, whereas more primary care clinic providers would schedule a follow-up appointment. Neither group of providers mentioned assessing common postconcussive symptoms of fatigue, emotional changes, and problems sleeping. Comparing findings to current literature suggest that added focus on emotional, cognitive and psychosocial factors, and education of the patient and family could improve early identification of mild TBI patients at risk for poor recovery.
authors.affiliation: Defense and Veterans Brain Injury Center, Wilford Hall Air Force Medical Center, P.O. Box 27376, San Antonio, TX 78227, USA.
authors.forename: Jan Elizabeth
authors.initials: JE
authors.lastname: Kennedy
authors.forename: Robin James
authors.initials: RJ
authors.lastname: Lumpkin
authors.forename: Joyce Rothleder
authors.initials: JR
authors.lastname: Grissom
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000592:standards*; D019538:Health Care Surveys; D006772:Hospitals, Military; D006801:Humans; D011320:Primary Health Care / Q000592:standards*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D013781:Texas; D016896:Treatment Outcome