Treatment and Acute Care for TBI

Chapter 7 – Treatment and Acute Care for TBI

Immediate Care After a TBI

Treatment for traumatic brain injury (TBI) begins as soon as possible after the injury. The goal is to:

  • Prevent further brain damage
  • Keep oxygen and blood flowing to the brain
  • Control swelling and pressure inside the skull

If someone shows signs of a serious TBI—like loss of consciousness, confusion, or seizures—they should get emergency medical care immediately.

Emergency Treatment

In the hospital, emergency teams may:

  • Give oxygen to help breathing
  • Monitor blood pressure and vital signs
  • Insert tubes to help breathing if needed
  • Treat bleeding or fractures in the skull
  • Give medications to reduce swelling in the brain
  • Use imaging scans (CT or MRI) to look for damage

Severe cases may require surgery right away to:

  • Remove blood clots (hematomas)
  • Repair skull fractures
  • Relieve pressure in the brain

Managing Intracranial Pressure (ICP)

A big concern after TBI is swelling inside the brain, which raises intracranial pressure (ICP). High ICP can damage brain tissue. Doctors may:

  • Place a monitor inside the skull to measure pressure
  • Use medications to reduce swelling
  • Drain fluid from around the brain
  • Lower body temperature (hypothermia therapy) to slow swelling
  • Raise the head of the bed to improve blood flow

ICU Care

People with moderate or severe TBI often stay in an Intensive Care Unit (ICU). In the ICU, the team carefully watches for:

  • Changes in brain pressure
  • Seizures
  • Infections
  • Problems with breathing or circulation

Stabilizing the patient is the first step before moving on to rehabilitation.

Medications Used in Acute Care

Common medicines given right after a TBI include:

  • Diuretics – Help reduce fluid buildup in the brain
  • Anti-seizure medications – Prevent or treat seizures
  • Coma-inducing drugs – In severe cases, doctors may temporarily induce a coma to help the brain heal

Doctors carefully choose medications based on the patient’s condition.

Early Rehabilitation Starts Early

Even in the hospital, rehabilitation may begin as soon as the person is medically stable. Early rehab might include:

  • Gentle exercises to keep muscles from stiffening
  • Positioning to prevent bed sores
  • Simple tasks to stimulate thinking or memory
  • Speech or swallowing assessments

The sooner rehab starts, the better the chance of reducing long-term disabilities.

Emotional Support for Families

TBI doesn’t just affect the patient—it deeply impacts the family. Families often feel:

  • Shock and fear
  • Confusion about medical terms
  • Overwhelmed by decisions

Doctors, nurses, and social workers can help explain the situation and connect families to resources.

The Road Ahead

Acute care is only the beginning of recovery from TBI. The next step is rehabilitation, where the patient learns to regain lost skills and adapt to new challenges. Recovery is different for every person—but with time, therapy, and support, improvement is possible.

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