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While many may be rejoicing in the fact that guidelines for the management of severe traumatic brain injury (TBI) have been updated for the first time since 2007, it’s important that we don’t get too excited. MedPage Today recently reported on the insufficiencies of the new guidelines regarding severe TBI management. According to MedPage Today, 189 publications provided evidence to support 28 recommendations on 18 different topics in Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Although there have been major breakthroughs in many areas of severe TBI management, many recommendations in key areas were not included in the new guidelines, making them incomplete for clinical use.

Individual Clinical Environments

At this point, advocates are calling on clinicians to tailor specific treatment and management protocols to their individual clinical environments. Clinicians should also rely on their practical experience and clinical observations in deciding when to use particular treatment approaches that may not have been included in the new guidelines. For example, although there hasn’t been sufficient traditional clinical evidence to support the use of hyperosmolar agents to improve outcomes, many clinicians have reported success in their practices.

Critical Evidence Gaps

Although the much-needed update in the guidelines for the management of severe TBI has important new information for clinicians, it still lacks answers to some very significant questions. Due to a lack of clinical evidence, many potentially critical management strategies and practices have not been included. These evidence gaps can mean a negative impact to patients and their families. We need additional research on many of the latest state-of-the-art methods that can improve outcomes for people suffering from severe TBI. Furthermore, taking into account observational studies and other less traditional and time-consuming clinical studies could mean more access to treatment and management options for patients that need them, much sooner.

Severe TBI Management Outlook

Clinicians that are at the forefront of severe TBI management and treatment know that relying on these recently updated, and still outdated guidelines could mean insufficient care and treatment of their patients.

So what’s the answer when a family member suffers a severe personal injury? In our practice we have cared for survivors of TBI and as you would expect have worked with a wide range of doctors serving our clients. Our experience over 40 years is this: Always demand medical care at a Level 1 Trauma Center. In Santa Clara County Santa Clara Valley Medical Center, Regional Medical Center and Stanford Hospital are all level 1 choices for the best possible care.

Alexander Law Group, LLP is always ready to answer questions and share the results of our research and experience with the public. Our goal is to make a difference for our clients and our community.