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TBI task force identifies shortfalls in care

An Army report on the cause, diagnosis and treatment of traumatic brain injuries among soldiers and Marines who have been in combat cited a number of gaps in services and care for those suffering TBI.

One in five soldiers and Marines returning from Iraq and Afghanistan may have suffered mild TBI, the task force estimated, and some may not be aware they need treatment.

“Many of the mild cases are overlooked,” Brig. Gen. Donald Bradshaw, commander of the Southeast Regional Medical Command and chairman of the TBI Task Force, said Jan. 17 at a press conference to release the report.

The task force of 17 medical professionals, writers and researchers from the Army, Marine Corps and Air Force conducted a review of policies governing TBI patient care, including diagnosis, education, research and case management.

The study was conducted between January and May. Task force members visited dozens of sites in the U.S., Germany and Puerto Rico, where they interviewed soldiers, family members, caregivers and TBI experts in and out of the military system.

Though the task force found that the Army has made important progress in the identification and treatment of severe or penetrating TBI, the mild form of the injury, similar to a concussion with symptoms such as headache, sleeplessness or grogginess, has been harder to detect and catalog.

Troopers exposed to blasts are checked immediately after the event in theater through a standardized test called the military acute concussion evaluation, a screening tool that uses a series of questions and observations by medical personnel to make an initial evaluation.

Among the shortfalls found by the task force was that identification and documentation of TBI was not standardized across the Army, nor were educational tools for soldiers, leaders and family members.

The task force also found “inefficient communication among levels of care” and within records-keeping systems, “which places an undue burden on family members to play the role of record keeper, communicator, advocate, and case manager.”

The task force proposed a number of steps to improve the screening and treatment of TBI cases.

The report can be seen online at http://www.armymedicine.army.mil/news/news.html.