Picking Up The Pieces
Updated: Jul 4
I’m here. I’m not going anywhere. No matter what the injury – unless it’s completely debilitating – I’m going to be the same player I’ve always been. I’ll figure it out. I’ll make some tweaks, some changes, but I’m still coming.
“Dispatch! Priority! Please send any available units to our location. We have one dead black female on the side walk and possibly more victims inside of a vacant house; the shooter is on foot and armed with a semi-automatic weapon.” Riding in the passenger seat, I replied, “Radio scout 2 – 4 is headed to that location”. My partner Owens, the driver for the day, picked up speed heading to the location, and I activated the over-head oscillating lights and sirens. While this was an extraordinary situation for others, this was a normal afternoon for those with 8 years on the force. As we drove northbound on the street that the crime scene was located on, we saw lights from the scout car that was now requesting our time of arrival. As we approached the last intersection before the address, I screamed, “J, break!” The loud crash of metal smashing sounded like a bomb exploding. Our scout car is now spinning in a constant 360-degree motion barely missing an elderly woman who was standing on the sidewalk. Our car finally came to a halt after crashing into another car that disregarded a stop sign. When the Patrol Sergeant came to see the damage, he immediately called the EMS and ordered us to the hospital. The doctors performed x-rays, EKGs and treated us for visible injuries. They prescribed pain medication, physical therapy, and rest, and sent us back to work, the whole time missing the invisible wound. Traumatic Brain Injury (TBI) often goes undiagnosed in these types of situations because the injury is often times unseen. Primary care physicians and first responders should have a standard protocol as the military does on how to handle Traumatic Brain Injury (TBI) victims.
As research continues, the military adjusts how it handles TBI’s for Primary Care Physicians and First Responders. Currently, the military has a protocol for dealing with TBI’s. A group of officials at the Defense and Veterans Brain Injury Center has compiled treatment and recovery guidelines for brain related injuries. New guidelines mandate 24-hour rest periods following a concussion. If abnormal symptoms are observed once the patient returns to normal activity, then a six-step treatment is put into place. The steps offer a recovery phase that very slowly transitions the patient from rest to unrestricted activity. This is an effort to give the brain time to heal without causing further trauma. “Traumatic brain injury is a common battle-related injury. Treatment goals in the first 72 hours of care for the injured patient with TBI are to provide clinical stability, arrest any element of ongoing injury, preserve neurological function, and prevent medical complications secondary to multisystem trauma” (Lenhart, 348). The national spotlight, highlighting further research of concussions, was focused on athletes, but it has been determined that guidelines for first responders are necessary. First responders require the ability to meet specific physical demands, to make decisions under stressful conditions, and to multitask in life or death circumstances.
There is growing evidence that the management of TBI in the early minutes after injury profoundly affects outcome. Primary Care Physicians and First Responders would have the ability to reduce the number of emergency room visits, hospitalizations, and deaths in the United States if there was standard protocol on how to deal with brain injuries. The early minutes after an injury are the most crucial in relation to the outcome of the brain injury, yet there is currently no requirement for standard protocols. Excellence in Prehospital Injury Care (EPIC) is a statewide project in Arizona with a goal of establishing EMS TBI guidelines. EPIC believes that if first responders have the tools and training to implement in cases of brain injury, just as they do for cardiac arrest, there will be an increase of successful outcomes for those that suffer a brain injury.
Over 1.7 million Americans experience a Traumatic Brain Injury (TBI) every year in the United States and 53,000 die from their injuries. The often-misdiagnosed injury affects every sex, race, and age. A Traumatic Brain Injury is often an invisible injury with lifelong ramifications, the treatment of which requires a strong support system, therapies that encourage the best possible quality of life, and clear expectations on how to rebuild life after it falls apart. Mandating civilian Primary Care Physicians and first responders to follow the military standard of treatment would greatly improve the quality of life for TBI victims. My on-duty car accident was one of many situations where I suffered an untreated concussion. Brain injury victims are not receiving the necessary care immediately following an injury because a precedent has not been set for Primary Care Physicians and First Responders to know how to care for such victims. With it being difficult to treat an unseen injury, there should be checks and balances in place for situations where the injury warrants it. Multiple head injuries, even those considered as minor injuries have long-term health consequences, with each injury adds to the brain’s inability to heal. The mandated protocol contributes to recovery rates that improve by preparing Primary Care Physician’s and First Responders to better address TBI victims.
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