Management of Wounded Warriors

Current combat operations have resulted in a high rate of wounded US service members (www.dvbic.org/dod-worldwide-numbers-tbi). Blast-related injuries account for numerous combat injuries, and many of these wounded warriors have symptoms of traumatic brain injury (TBI). With the success in managing combat trauma through improved body armor, surgical care near the battlefield and rapid evacuation to major hospitals, the survival rate is greater than 90%. These wounded warriors require specialized care from providers with experience in treating traumatic brain injury. Data has shown that upwards of 95% of patients who have sustained a mild TBI (concussion) will fully recover with no long-term effects (DVBIC).

Within the Department of Defense (DoD) and the Department of Veterans Affairs (DVA), the Defense and Veterans Brain Injury Center (DVBIC) has clinical care and research programs at several military sites, five VA facilities and two civilian partner programs. These DVBIC sites work collaboratively to provide and improve TBI care for active duty military, veterans and their eligible beneficiaries. These sites are listed at the following Web site: www.dvbic.org/Locations.

The military medical centers are:

The VA Brain Injury Centers are:

  • James A. Haley Veterans Hospital, Tampa, Florida
  • Minneapolis VA Medical Center, Minneapolis, Minnesota
  • Palo Alto VA Medical Center, Palo Alto, California
  • Hunter McGuire VA Medical Center, Richmond, Virginia
  • Veterans Affairs Boston Healthcare System, Boston, Massachusetts

The two civilian partner programs are:

  • Laurel Highlands Neuro-Rehabiliation Center, Johnstown, Pennsylvania
  • Lakeview Virginia NeuroCare, Inc, Charlottesville, Virginia

International Military Locations

  • Landstuhl RMC, Germany
     

Treating Wounded Warriors

Currently, the process for the care of wounded warriors occurs as follows:

1. The wounded warriors are screened and treated in the theater.

2. If needed, service members who are still on active duty will go to a DoD hospital or outpatient care, but they may be referred to a VA facility or civilian care if that better meets their clinical needs.

3. If needed, they may be referred to a polytrauma inpatient care facility (VA center).

4. After inpatient rehab, they can return to a major medical center for outpatient care or can return to duty (reservists could be returning to community based care).

With the current conflicts in Iraq and Afghanistan baseline predeployment neurocognitive assessments are being completed for service members. The VA screens all veterans for possible TBI when they come to the VA for care. Referrals to polytrauma teams are made for veterans with positive screens. Injured service members are more likely to enter VA care after they leave active duty status, especially if they separate, rather than retire from service.

For more information on the screening process for TBI, visit www.dvbic.org/care-coordination.

Joining Forces Initiative

First Lady Michelle Obama and Dr. Jill Biden launched Joining Forces as a comprehensive national initiative to mobilize all sectors of society to give our service members and their families the opportunities and support they have earned. It is designed to bring attention to the unique needs and strength of America's military families while showcasing the skills and dedication of America's veterans and military spouses. The initiative will highlight employment, education, and wellness as issues of special importance to military families across the country.

APTA was honored to be invited by the Office of the First Lady to participate in this initiative. Learn more.

Other Related Resources

Traumatic Brain Injury (TBI)  

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment - July 13, 2012 Report 

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