Brain Trauma Foundation

The Brain Trauma Foundation (BTF) was founded in 1986 to develop research on traumatic brain injury (TBI). Since its formation the foundation's mission has expanded to improving the outcome of TBI patients nationwide through working to implement evidence-based guidelines for prehospital and in-hospital care, quality-improvement programs, and coordinatingeducational programs for medical professionals.

TBI Guidelines

The Brain Trauma Foundation has developed the "Guidelines for the Management of Severe Traumatic Brain Injury", first published in 1995 and revised twice, most recently in 2007. The foundation has also developed companion guidelines for pediatric TBI, prehospital management of TBI, early indicators and prognosis of severe TBI, surgical management of TBI, and field management for combat medics. The guidelines seek to create uniformity in TBI care all over the world. [ Citation
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publication-date= May, 2007
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An independent analysis of the effect of the Brain Trauma Foundation’s (BTF) guidelines on traumatic brain injury (TBI) outcome and cost savings by the Centers for Disease Control and Prevention (CDC) found that if the BTF guidelines were used more routinely, there would be a 50% decrease in deaths, improved quality of life and a savings of $262 million in annual medical costs, $43 million in annual rehabilitation costs and a lifetime societal cost of $3.84 billion. [Citation
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first=Mark
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first2=Marlena
last3=Rutland Brown
first3=Wesley
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last5=Sattin
first5=Richard
year=2007
date=December
issue=63(6)
contribution-url=
title= Using a Cost-Benefit Analysis to Estimate Outcomes of a Clinical Treatment Guideline: Testing the Brain Trauma Foundation Guidelines for the Treatment of Severe Traumatic Brain Injury.
periodical=Journal of Trauma-Injury Infection & Critical Care
pages=1271-1278]

The guidelines have been endorsed by the American Association of Neurological Surgeons, the World Health Organization Neurotrauma Committee, and the New York State Department of Health. The guidelines have been distributed to all neurosurgeons in the United States. The guidelines provide medical personnel a protocol which has been proven to improve the survival and outcomes of TBI patients and has been shown to reduce rates of mortality. [ Citation
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last2=Trask
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issue=56
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title=Management of Brain-injured patients by an evidence-based medicine protocol improves outcomes and decreases hospital charges
periodical=J Trauma
pages=492-499, discussion 499-500] [Citation
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first=S
last2=Qureshi
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year=2001
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issue=50
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title= The impact on outcomes in a community hospital setting of using the AANS traumatic brain injury guidelines Americans Associations for Neurologic Surgeons
periodical=J Trauma
pages=657-664'] [Citation
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first=HC
last2=Menon
first2=DK
last3=Tebbs
first3=S
year=2002
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issue=28
contribution-url=
title= Specialist neurocritical care and outcome from head injury.
periodical=Intensive Care Med
pages=547-553]

Intracranial pressure (ICP) monitoring

One of the main facets of the guidelines is the recommendation to monitor intracranial pressure in treating severe TBI patients. This process is called ICP Monitoring.

When the brain suffers severe trauma it begins to swell inside the skull. If the brain swelling goes undetected and is not treated the brain becomes deprived of oxygen-rich blood and "starves". This secondary injury causes permanent brain damage. With ICP Monitoring, which tells doctors how much swelling the brain has sustained and can drain cerebrospinal fluid, which would relieve some of the pressure, this outcome can be prevented.clarifyme

In the United States surveys conducted in 1995, 2000 and 2006 have shown that since 1995 (the year the TBI Guidelines were published) ICP Monitoring rose from 32% to 78% in 2005. [ Citation
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first3= RK
publication-date= 1995
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periodical= Crit. Care Med
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volume=23
pages=560-567
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last2= Ghajar
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publication-date= 2002
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periodical= J Trauma
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volume=52
pages=1202-1209
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last=Hersdorffer
first=DC
last2= Ghajar
first2= J
publication-date= 2007
date=
title=Marked improvement in adherence to traumatic brain injury guidelines in United States trauma centers
periodical= J Trauma
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volume=63
pages=841-848
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Board of Directors

* Jamshid Ghajar, M.D., Ph.D., President
* Pamela Drexel, Executive Director
* Alan Quasha, Chairman

Medical Advisory Board

* M. Ross Bullock, MD, PhD, Chairman – Virginia Commonwealth University
* Mary Kay Bader, MSN,CCRN,CNRN – Mission Hospital Regional Medical Center
* Robert M. Domeier, MD – National Association of EMS Physicians
* James Ecklund, MD, FACS – Walter Reed Army Medical Center
* Thomas J. Esposito, MD, MPH, FACS – Loyola University
* Steven R. Flanagan, MD – Mount Sinai School of Medicine
* Thomas A. Gennarelli, MD – Medical College of Wisconsin
* Ronald L. Hayes, PhD – Banyan Biomakers, Inc.
* E. Brooke Lerner, PhD, EMT-P – Medical College of Wisconsin
* Peter B. Letarte, MD, FACS – Loyola University Medical Center
* Harvey S. Levin, PhD – Baylor College of Medicine
* Andrew I.R. Maas, MD, PhD – Enasmus Medical Center, Rotterdam, Netherlands
* Geoffrey T. Manley, MD, PhD – University of California, San Francisco
* Michael Pasquale, MD – Lehigh Valley Hospital
* Peter T. Pons, MD, FACEP – University of Colorado Health Sciences Center
* Claudia Robertson, MD – Baylor College of Medicine
* Franco Servadei, MD – M. Bufalini Hospital, Cesena, Italy
* John Whyte, MD, PhD – Moss Rehabilitation Research Institute

References

External links

* [http://www.braintrauma.org/site/PageServer?pagename=homepage Brain Trauma Foundation]