Brooklyn

Published on: March 18, 2012

Care for victims of traumatic brain injury (TBI) starts on the battlefield, according to “Guidelines for Field Management of Combat-Related Head Trauma”

by Stephen Bilkis

Care for victims of traumatic brain injury (TBI) starts on the battlefield, according to “Guidelines for Field Management of Combat-Related Head Trauma”, doctors have learned. The combat medic works hard to prevent further harm from coming to the victim. The basics, such as the ABCs of airway, breathing, and circulation are tended to before work on the actual injury begins.

Once the patient is stabilized, the severity of the brain injury is determined, which helps form the basis of triage decisions. Someone who is less injured can be evacuated to a better facility than a field hospital. Some of these need to be moved by helicopter or some other expeditious manner. A blast from something like an improvised explosive device (IED) often results in multiple injuries, which need to be managed all at once.

The combat support hospitals in the Bronx and Brooklyn are the places for a more detailed assessment of injuries. When it comes to blast trauma, neuroimaging with CT scans should be done as soon as possible. It is important to identify things like intracranial hemorrhage, skull fractures, or cerebral edemas before they develop into something worse. Often it is necessary to perform emergency neurosurgery, studies have discovered.

Published on: February 27, 2012

Explosive blast traumatic brain injury (bTBI) can be a complicated thing

by Stephen Bilkis

Explosive blast traumatic brain injury(bTBI) can be a complicated thing, doctors have learned. The Centers for Disease Control and Prevention have determined secondary, tertiary, and even quaternary effects that may contribute to a particular patient’s condition.

The primary injury comes from the forces created by the explosion itself. Secondary injury might occur due to matter thrown by the explosion, like fragments from the weapon itself, or debris in the immediate environment. Tertiary injury occurs when the victim is thrown by the blast to strike a wall or the ground. Finally, quaternary injuries may occur from factors not included in the first three, like burns or inhalation of toxic fumes.

Experts have seen that the injuries can cause a number of symptoms. It might be as mild as a brief period of confusion – or it may lead to a coma. Severe bTBI commonly leads to diffuse cerebral edema and hyperemia, developing rapidly, within an hour after the initial blast injury. This type of injury seems to be much more common with blasts, as opposed to other forms of traumatic brain injury, and this type of injury has lead to military neurosurgeons performing more decompressive craniectomies more often than they would for penetrative traumatic brain injury (pTBI) or closed head traumatic brain injury (cTBI).

Published on: February 5, 2012

Negligent Hospital Pays $5 Million Settlement

by Stephen Bilkis

A hospital found negligent was forced to pay out a birth injury settlement in the amount of $5 million to a 30-year-old woman whose child suffered severe birth injuries. The injuries were a direct result of medical malpractice.

A study reports that medical records submitted to the court showed that the plaintiff’s medical history illustrated no dire warning – i.e. nothing to be concerned about. The woman had progressed through her first pregnancy normally.

However, the plaintiff’s midwife reported that the 30-year-old was admitted into the hospital in premature labor with a 2cm-dialated cervix. An external fetal monitor was placed on her abdomen.

Published on: January 27, 2012

In the war theater, the primary caregivers are often medics

by Stephen Bilkis

Diagnosing a concussion or mild TBI (traumatic brain injury) can be difficult, even to experienced physicians, especially on the battlefield, researchers have been told. Yet, that does not diminish the importance of diagnosing such an injury as soon as possible so the appropriate medical care can be given as soon as possible. If it isn’t, the warfighter may be return to duty at impaired status and the condition could even worsen over time.

In the war theater, the primary caregivers are often medics, who are not as extensively trained as physicians. They may not be able to recognize such subtle injuries as the ones caused by mild TBI. Often there are no cuts or bruises with these injuries. In fact, the patient may not even know he or she has sustained an injury. Others may hide evidence of an injury to remain with their unit.

It is important that medics and other medical providers need to watch out for bTBI (explosive blast traumatic injury) after any soldier has been in close proximity to an explosion, experts have discovered. The patient may even need to be referred to another strata of care, like a neurologist, neurosurgeon, or emergency medical physician.

Published on: December 25, 2011

Driver behavior is naturally an important component in preventing injuries

by Stephen Bilkis

Driver behavior is naturally an important component in preventing brain injuries of any kind, including head injuries, doctors note. The threat of legislative penalties does a great deal to influence risk-taking behavior. For instance, laws making the use of seatbelts mandatory increases the use of seatbelts, which decreases the rate of injury dramatically.

No matter where it is employed, the enactment of seatbelt laws tend to reduce the incidence of vehicle accident related head injury. Studies all over the United States, as well as some in European countries, confirm this time and again.

There is still a problem, with some cars, with the steering wheel causing severe brain injury in accidents, even when seatbelts are employed. The use of driver’s side airbags reduce even these injuries. Experts in Brooklyn and Long Island say, however, that an airbag should always be used in conjunction with a seatbelt, not as a replacement for one.

Published on: December 21, 2011

The chaos of war only compounds the difficulty in making decisions

by Stephen Bilkis

Sometimes the extent of moderate or severe damage caused by bTBI (explosive blast traumatic brain injury) is difficult to determine at first, doctors have told reporters. Severe facial trauma can prevent reliable neurological examination, especially when it comes to examining the pupils for reaction. Specialized tools are often necessary to even make triage decisions that could save lives.

The chaos of war only compounds the difficulty in making decisions when it comes to severe injury. When a doctor or other medical professional is used to medical centers in the United States, where there are adequate resources and help in the form of other professionals near at hand, it can be very difficult to work on a battlefield where everything is in short supply, but the number of patients is much greater.

Difficult decisions have to be made in such environments, officers have learned. It isn’t uncommon for a great number of severely injured patients to arrive at the same time. Efficient triage is essential for the best use of limited resources. There may be few health care providers, no operating rooms or CT scanners, and not many blood products to go around. It may even be impossible to evacuate patients to a better facility. The whole idea behind triage is take resources that may not be adequate and stretch them out to their best possible use to help the largest number of patients with brain injuries. They must be stabilized and their lives preserved until they can be evacuated into a better circumstance.

Published on: December 17, 2011

Driver behavior is naturally an important component in preventing injuries of any kind

by Stephen Bilkis

Driver behavior is naturally an important component in preventing injuries of any kind, including head injuries, experts note. The threat of legislative penalties does a great deal to influence risk-taking behavior. For instance, laws making the use of seatbelts mandatory increases the use of seatbelts, which decreases the rate of injury dramatically.

No matter where it is employed, the enactment of seatbelt laws tend to reduce the incidence of vehicle accident related head injury. Studies all over the United States, as well as some in European countries, confirm this time and again.

There is still a problem, with some cars, with the steering wheel causing severe brain injury in accidents, even when seatbelts are employed. The use of driver’s side airbags reduce even these injuries. Studies in The Bronx and Brooklyn say, however, that an airbag should always be used in conjunction with a seatbelt, not as a replacement for one.

Published on: November 30, 2011

Motor vehicles are now specifically made to both be easier to drive and more durable so the passengers have less chance of injury

by Stephen Bilkis

Doctors have noted another big factor in the prevention of head injury and brain injury including concussions: motor vehicle design. When the vehicle is less likely to crash and crashes are made more survivable, lives will be saved. Motor vehicles are now specifically made to both be easier to drive and more durable so the passengers have less chance of injury. Most car manufacturers test their vehicles thoroughly, and safety standards are now government policy in many developed countries.

Better engine performance, better lights, better steering, and other aspects of better car design have become more prominent over the last few decades. While it is sometimes difficult to determine that good car design prevents crashes, it can be proven that poor car design is dangerous. Ralph Nader’s famous work, ‘Unsafe At Any Speed’ has been cited by many as the work that impelled car designers to take a closer look at their manufacturing policies and the public at large to consider car safety an important factor in their automobiles. Trained observers in Brooklyn and Long Island have also seen that the occupants of larger vehicles tend to be more safe than the occupants of smaller vehicles.

Cars can be designed to be safer and reduce head injury, by absorbing the impact when it comes to a crash, that would otherwise harm the occupants. Things like crumple zones protect from frontal crashes, but side impacts are more difficult to plan for. Most modern car designs have removed any interior protrusions, so penetrating injuries are now much less common in car accidents than they once were

Published on: November 17, 2011

The way surgeons deal with shrapnel or bone fragments in the brain has changed since the days of Korea or Vietnam

by Stephen Bilkis

The way surgeons deal with shrapnel or bone fragments in the brain has changed since the days of Korea or Vietnam, doctors tell reporters. It was once the standard to remove every last fragment of bone or any other foreign body, so the brain would have a lower risk of infection and there would be less chance of developing post-traumatic epilepsy. Studies of Vietnam War patients has shown that removal of all fragments is not actually necessary, though objects that cause gross contamination should still be removed.

Closure of the scalp and replacement of the dura are absolutely vital to prevent, or at least reduce the chance of, CSF leakage and meningitis. A soldier who seems to have good neurological status, with only small fragments in the brain may be able to be treated locally to prevent leakage. One with a more extensive injury will have to undergo a large decompressive creniectomy and removal of the fragments.

Another source of head injury from an explosive blast can result from being bodily thrown by the explosion. The soldier’s head could strike some other object, causing tertiary blast injury. This can cause injuries in a number of places in the patient’s skull. There is also the risk of infection in cases such as these, often from bacteria that are drug-resistant. A number of dangerous injuries can result from such a brain trauma. It can be very important to repair such injuries as facial fractures quickly. Doctors in Manhattan and Brooklyn know this.

Published on: November 10, 2011

Diagnosing a concussion or mild TBI (traumatic brain injury) can be difficult

by Stephen Bilkis

Diagnosing a concussion or mild TBI (traumatic brain injury) can be difficult, even to experienced physicians, especially on the battlefield, New York Brain Injury Lawyers have been told. Yet, that does not diminish the importance of diagnosing such an injury as soon as possible so the appropriate medical care can be given as soon as possible. If it isn’t, the warfighter may be return to duty at impaired status and the condition could even worsen over time.

In the war theater, the primary caregivers are often medics, who are not as extensively trained as physicians. They may not be able to recognize such subtle injuries as the ones caused by mild TBI. Often there are no cuts or bruises with these injuries. In fact, the patient may not even know he or she has sustained an injury. Others may hide evidence of an injury to remain with their unit. Hospitals in The Bronx and Brooklyn are aware of these circumstances.

It is important that medics and other medical providers need to watch out for bTBI (explosive blast traumatic injury) after any soldier has been in close proximity to an explosion, New York Brain Injury Lawyers have discovered. The patient may even need to be referred to another strata of care, like a neurologist, neurosurgeon, or emergency medical physician.