Critical Care Of Traumatic Brain Injury Toronto
Traumatic brain injury Toronto (TBI) is the primary cause of death in young people. The main causes of TBI are road traffic accidents, falls, sports and, most recently, blast trauma in the armed forces. The Traumatic Brain Foundation (TBF), founded in 1986, developed a set of guidelines, based on clinical research, for the treatment of coma resulting from TBI.
The first set of TBF guidelines were published in 1996. They were approved by the American Association of Neurological Surgeons and by the World Health Organization (WHO). They were subsequently updated in 2000, 2003 and 2007.
The principal objectives of the TBF guidelines are to prevent and treat raised intracranial blood pressure, maintain blood flow and oxygen levels and to prevent secondary damage. In practice, treatment protocols that incorporate these guidelines result in better outcomes in terms of mortality rate, costs, length of hospital stay and function.
TBI takes place in two discrete phases. The first phase is primary damage resulting from the immediate, direct physical trauma to the head. This results in compression and shearing of the cerebral tissue and blood vessels of the surrounding area. This damage is irreversible. Secondary damage, however, does respond to interventions to retard further damage or to reverse secondary damage that may already be present.
Secondary is further divisible into intracranial trauma (swelling, bruising, intracranial hypertension, calcium toxicity, disturbances in metabolism, seizures, infection and narrowing of the arteries). The other type of secondary damage is mostly ischemic, arising from a reduced supply of blood.
Critical care of individuals who suffer traumatic brain injury Toronto starts where the accident happened. In between the original injury and admission to ICU, the patient will pass through the emergency department, radiology and the operating room. Attention to TBF advice is especially critical during what is know as the Golden Hour, the first hour following the initial impact to the head. brain injury toronto
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