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The ILS is a comprehensive tool for assessing activities of daily living, behavior and initiation skills following traumatic brain injury.
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Fall Issue 2009
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Concussion Tissue Damage
TBI Treatment Wrong?
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TBI Haunts Children
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Drug Treats TBI
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Brain Injury Overview CEU Course

CEU Course

Brain Injury and Rehabilitation:
An Overview


Levels of Care

The medical community and rehabilitation care system of the Unties States for individuals with severe TBI is divided into several different levels. The levels of care are usually entered on a sequential basis, based upon the stage of recovery after the initial injury. The first six or so treatment settings-after acute inpatient rehabilitation-are common to many individuals with severe TBI. The rest, after acute rehabilitation, are highly variable from individual to individual depending on a number of factors; adequate funding being a major factor. On the following pages are short descriptions of the common levels of treatment care after TBI:

Emergency medical services - These individuals are trained in basic life-support and are usually the first persons on the scene of a severe accident. After severe TBI, the goal of these individuals is to sustain life, stabilize the individual's vital signs, as much as possible, and provide immediate and speedy transport to a hospital emergency room or designated trauma center.

Emergency room - Is where initial evaluation, stabilization, and treatment occurs. After severe TBI, an emergency, trauma, or neurosurgeon physician evaluates the individual and often will perform initial x-rays and CT scans to determine the extent of injury.

Surgery - Is where surgical operations are performed. After severe TBI, bleeding in the brain or skull fractures may be present and may require surgical repair.

Intensive care unit - Has the maximum nursing and physician direct care and management because of the unstable or critical condition present after most severe TBI's. This unit treats injuries, provides for adequate airway and nutrition, and prevents secondary infections and complications while the natural recovery process takes place. TBI patients are often provided with some basic sensory and physical stimulation to attempt to facilitate recovery.

Neurological unit - Is where the intensity of care is somewhat reduced but still is significant in the form of medical and nursing care. The individual may still be profoundly unconscious. Physical and occupational therapists now begin working with the TBI patient to provide passive range-of-motion exercises to prevent stiffening of the joints and atrophy of the muscles. When medically stable, the individual is usually transferred to a rehabilitation unit.

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