Impact of a Systematic Protocol in the Icu Management of Traumatic Brain Injury Tbi Essay
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Impact Of A Systematic Protocol In The ICU Management Of Traumatic Brain Injury (TBI)
Traumatic brain injury (TBI) is an important public health problem and is the leading cause of mortality & morbidity. In TBI, Primary injuries result from the mechanical trauma  and leads to secondary injury. Secondary injury occurs gradually and may involve an array of cellular processes and plays a large role in the brain damage and deaths those results from TBI. However, since secondary injury occurs over time, it can be prevented in part by taking measures to prevent complications such as Hypoxia, Edema, Impaired metabolism, Altered cerebral blood flow and Excitotoxicity.
Large body of evidence exists supporting the importance of preventing secondary brain insults. Various studies showed considerable variation in the care of patients with severe TBI [3-5]. To improve and standardize neurocritical care management, a protocol was developed by ICU team and was discussed and agreed upon by the neurosurgical team. To develop the protocol, a multidisciplinary neurotrauma task force was formed with representatives from all of the associated medical, nursing, and ancillary specialties. The protocol was introduced in February 2001. The purpose of the protocol was to provide a standardized ICU management based on current guidelines developed by Brain Trauma Foundation (BTF) to reduce secondary brain insults [6-8].
The concept of secondary brain insult was recognized 20 years ago [9-10]. However, the impact of a systematic protocol in the ICU management of traumatic brain injury (TBI) in prevention of secondary brain insult has not been well examined. Few studies are carried out which has been found reporting the impact of systematic ICU protocol in TBI . The purpose of this study was to examine the effect of the implementation of clinical practice