Over the past 8 years, advances in the US Military Health System (MHS) have led to extensive changes in the way combat casualty care is provided to deployed service members with a traumatic brain injury (TBI). Changes include the application of cutting-edge Clinical Practice Guidelines, use of pioneering technologies, and advances in evacuation procedures. Compared with previous engagements, current operations occur on a much smaller scale, and more frequently in austere environments, such that effective medical support is increasingly challenging. In this paper, the authors describe key aspects of the current continuum of TBI care in the US military, from the point of injury through rehabilitation, with an emphasis on how emerging technologies and evidence-based Clinical Practice Guidelines assist MHS clinicians with providing the best clinical care possible in the changing battlefield.
Keywords: CPG = Clinical Practice Guideline; CoSCCC = Committee on Surgical Combat Casualty Care; DVBIC = Defense and Veterans Brain Injury Center; Department of Defense; DoD = Department of Defense; ICP = intracranial pressure; ISC = Intrepid Spirit Center; JTS = Joint Trauma System; MHS = Military Health System; MTF = military treatment facility; Military Health System; NDAA = National Defense Authorization Act; NICoE = National Intrepid Center of Excellence; OEF = Operation Enduring Freedom; OIF = Operation Iraqi Freedom; OND = Operation New Dawn; TBI = traumatic brain injury; VA = Veterans Affairs; levels of care; service member; traumatic brain injury.