New Policy from the Department of Defense Aims to Better Identify and Treat Concussions

According to Army Maj. Sarah Goldman, "This is an absolutely revolutionary policy. This is the first time in traumatic brain injury care, and certainly in the Department of Defense traumatic brain injury care, that we have an event-driven protocol. It means that you don't have to rely on service members to report problems after they have been involved in an event." "It is an event-driven policy meaning the if a service member hits their head, or is somewhere near a blast, they have to get checked out, they have to get treated, and it has to be reported. There is also mandatory down time for recovery." DOD officials have struggled with ways to more quickly identify and treat the often invisible combat injury.

Traumatic brain injuries often result from bullet blasts, vehicle accidents that cause a jolt to the head, or exposure to a blast. Navy Cmdr. Dr. David Tarantino said that moderate and severe TBI's are relatively easy to recognize. The more challenging is the mild TBI, more commonly known as a concussion. He says that not diagnosing a service member with a mild TBI can have serious operational impact. They can have difficulty following instructions, poor marksmanship, slow reaction time, and decreased concentration. He says sending service members suffering from mild TBI back out onto the front lines can do a lot of harm.

The new memo requires commanders to ensure all service members involved in potentially concussive events receive a medical evaluation, even if they have no obvious or apparent injuries. It authorizes commanders to refer a service member under their charge, who appears to be showing symptoms, for an evaluation. It also mandates that all cases of TBI be documented into an electronic medical record. This documentation will provide a registry for the Defense Department and a tool to inform commanders whose units are about to redeploy.

Air Force Maj. Dr. Laura Baugh, the Air Force TBI program manager, called this leadership responsibility a key part of the new policy. She says, "It requires leaders to recognize service memebers who have been involved in an event that could cause a concussion and to ensure they get a medical evaluation and requires them to track these service members in the electronic database. Not only does this ensure service members get the follow-up care they need down the road, but it also helps the DOD understand the true incidence of this problem in the field."

In terms of patient care, it mandates two of the best-known treatments for mild TBI, rest and education. Troops suffering mild TBI require at least 24 hours of rest before returning to duty, and often more as they receive their medical evaluations. As the military works to improve the way it treats and diagnoses mild TBI, it is also focusing on more education for service members about TBI. Service members start their education in the pre-deployment cycle and continues through deployment and on redeployment home. This new policy is a big step in helping the military better identify and treat mild TBI and helps ensure that service members have the best chance at a full recovery.

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