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Emergency Room Considerations for People with Brain Injury Emergency Room Considerations for People with Brain Injury

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We know that every brain injury is unique, but in all cases, the acute care phase can be very important to a successful recovery. Dr. Bazarian, does it matter what hospital or emergency center a person is taken to after an accident, and what should they look for in order to get the best outcome? I think it's important for people who've had traumatic brain injury, and this is especially true with the more severe ends of brain injury, that they go to an emergency department that has the ability to perform a CAT scan rapidly, and then has a neurosurgeon that can be standing by ready to remove a blood clot that could be potentially life threatening. Now when someone is brought to the ER with a brain injury, what are the first concerns? We have several concerns when someone is first brought to emergency, and obviously these concerns will be a little bit different for someone at the milder end of things than at the severe end of brain injury. At the severe ends of traumatic brain injury--so someone who comes in and appears that they're in a coma, we're very concerned with securing their airway and making sure that they're breathing properly. Those 2 things are very important for limiting any susequent brain injury that they might have, and then thirdly, we also need to maintain their blood pressure. We do all these things as quickly as we can so that we can move on to getting the CAT scan, which is kind of a picture of their brain--really helps us know what we need to do next. Now at the milder ends of brain injury--the concussion--we're focused more on getting a CAT scan and figuring out what to do after that.

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Getting to an ER is crucial after a TBI, especially for an injury that is on the more severe side. The quicker doctors can do a CAT scan of the brain, the quicker they can act on their diagnosis.

This is an excerpt from BrainLine's webcast After the Injury: Acute Care and TBI. See full webcast here.

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Jeffrey Bazarian, MDJeffrey Bazarian, MD, Dr. Bazarian is an emergency physician with a strong research interest in traumatic brain injury. He is associate professor of Emergency Medicine, Neurology, and Neurosurgery at the Center for Neural Development and Disease, University of Rochester Medical Center.


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  • video content iconUsually the result of a serious brain injury, a subdural hematoma is a collection of blood on the surface of the brain. Understanding Subdural Hematoma
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  • video content icon Shearing is the stretching and tearing of the tiny nerve cells that comprise the brain. Learn more about the research and neuroimgaging that shearing can cause when the brain is injured. See more of Dr. Ghajar's videos here. Understanding the Nuances of Shearing Injuries in the Brain
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  • video content icon The standard medical guidelines published in 1995 have already significantly improved outcome, but more knowledge and change in doctors and the public is necessary to continue to improve outcome in people with TBI. See more of Dr. Ghajar's videos here. Using Knowledge for Better TBI Patient Outcome
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