New Emergency Room Guidelines for Mild Traumatic Brain Injury

The American College of Emergency Physicians in collaboration with the Centers for Disease Control and prevention (CDC) revised the clinical guidelines for mild brain injuries.  It is expected to lead to better patient outcomes for the more than one million patients who visit the emergency department every year for traumatic brain injury or concussion.

"People with traumatic brain injuries may appear to be normal and their symptoms may be mild, but there can be hidden dangers," said Richard Hunt, MD, Director of the Division of Injury Response at the Centers for Disease Control and Prevention. "TBI's can also lead to significant, life-long impairments that prevent a person's ability to function both physically and mentally.  These revised guidelines can help ensure that patients with even mild TBI's are identified early and receive the care they need."

The real incidence of traumatic brain injury is unknown since many patients who have an injury never get medical care.  The majority of these injuries are classified as mild, meaning the patient is alert, oriented and functional when they are assessed in the emergency department.

Nearly 10 percent of patients with a mild traumatic brain injury have evidence of an intracranial injury on head computed tomography (CT).  One percent of patients with mild traumatic brain injury harbor a life-threatening neurosurgical lesion.

The challenge for the emergency physician is to identify which patients with a head injury have an acute traumatic intracranial injury and which patients can be safely sent home.