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THE MAGAZINE OF AIR MOBILITY COMMAND

Medical Milestones for TBI

By MS. RITA HESS, Staff Writer

Autumn is such a treat for the senses: leaves crunching underfoot, frosty morning air on your cheeks, the aroma of crisp baked apples, and—wait! This safety article is supposed to be about FALL (an incident instead of the season)!

Let’s start over by discussing something Airmen already know. Depending on your job, you may be working high enough above the ground that a fall will most certainly kill you. Even if you survive, you may end up with a traumatic brain injury (or TBI), much like what service members can be exposed to during combat.

But it doesn’t just happen on the job. Indeed, a TBI is the result of any blow or jolt to the head that disrupts the normal function of the brain. It can be from the head striking an object (e.g., the ground) or from a flying or falling object striking the head. This means that in addition to the flightline, maintenance shop, training exercises, or combat, you can get a TBI while playing sports, driving a car, riding a motorcycle, or repairing a roof.

Brain injuries can also occur without a direct blow, such as with “whiplash” from violent shaking inside the skull, which is common in combat and motor vehicle crashes. This is often called an “invisible” wound.

More than 13,000 service members and veterans are diagnosed with a traumatic brain injury each year. Concussions (known as mild TBIs) sometimes go undetected or undiagnosed initially. More serious TBIs can cause nerve cells in the brain to stretch, tear, or pull apart—making it difficult for the brain to transmit messages to other parts of the brain or to the body.

TBI symptoms can be debilitating. They include headaches, dizziness, memory problems, irritability, trouble sleeping or concentrating, or sensitivity to light or noise. The injury can also cause behavioral, functional, or psychological changes. A critical treatment step is rest, allowing the brain to recover while reducing the risk of further damage.

Injuries can be life changing, but there is good news! Thanks in part to research funded by the Department of Defense (DoD) and the Army, marketing of the first-ever “brain trauma indicator” blood test was cleared by the Food and Drug Administration earlier this year, which should help with timely detection and thus better outcomes.

The test identifies two brain-specific markers that appear rapidly in the blood and remain elevated 12 hours following a head injury. These proteins indicate there may be blood (or a blood clot) in the brain, indicating a serious injury that might require surgery. Without the blood test, medical professionals must rely on reported symptoms or other signs to evaluate and treat patients.

The Army will begin limited user testing in early 2019. The device that runs the blood test is currently used in a laboratory, so it isn’t exactly portable. However, work is ongoing to make the machine smaller and to improve on the current 3- to 4-hour wait time for results.

More good news involves combining early diagnostics and a holistic treatment approach in a new facility at the 96th Medical Group at Eglin Air Force Base in Florida. Those who suffer with a TBI often fear being considered unfit for duty or suffering other adverse career effects, so they avoid getting help. But, as noted earlier, early diagnosis and the right treatment can actually provide a faster recovery.

“Unfortunately, a delay in care can lead to worsening TBI complications and greater impairments in functioning,” said Thomas Piazza, Medical Director of the Invisible Wounds Clinic. “This leads to outcomes worse than if the service member sought care sooner. That’s not just a problem for military readiness; it’s a problem for the individual and their families. The service member wants to be a part of their work and unit missions, but they just can’t.”

To achieve the best long-term outcomes, provider teams at the Air Force’s first comprehensive TBI center at Eglin will use a holistic approach. This involves treating the patient’s mind and the body as a whole—including the mental, physical, social, and spiritual pillars of health. The new clinic, which hopes to open in late 2018, will blend traditional medicine and procedures with tools such as acupuncture, art and music therapy, yoga, mind-body medicine, electrical nerve stimulation, and others.

Remember, a fall can have long-term consequences whether it happens on or off the job. In the case of a traumatic brain injury, early evaluation and treatment can shorten return-to-duty time and ensure a better recovery. If you suspect that you or someone you know may have a TBI from a fall or any other cause, seek medical attention as soon as possible.

DID YOU KNOW?

  • The majority of Airmen experience a TBI from a non-deployed setting due to the nature of their training or participation in sports and leisure activities.
  • Since 2000, more than 375,000 service members have been diagnosed with a TBI in training and combat situations, with the most common form being a mild TBI (also known as a concussion).
  • It’s estimated that 1.7 million people sustain a TBI annually. Of those diagnosed, approximately 50,000 die and 282,000 are hospitalized.
  • Unit readiness relies on early detection and timely treatment of brain injuries.
  • The vast majority of TBI cases are mild with a complete recovery within 7–10 days.
  • Your Military Treatment Facility has tools and resources to help educate Airmen, families, retirees, and DoD civilians about the prevention and treatment of TBI.

WANT TO KNOW MORE?

Air Force Medical Service – Traumatic Brain Injury Toolkit:
www.airforcemedicine.af.mil/Your-Healthcare/Healthy-Living/Health-Month/March/Traumatic-Brain-Injury-Toolkit

Air Force – Wounded Warrior Program:
www.woundedwarrior.af.mil

Air Force – Invisible Wounds Initiative:
www.woundedwarrior.af.mil/Airmen-Veterans/Invisible-Wounds-Initiative

Air Force Center of Excellence for Medical Multimedia – TBI:
www.tbi.cemmlibrary.org

Defense and Veterans Brain Injury Center – A Head for the Future:
http://dvbic.dcoe.mil/aheadforthefuture