New Data Reveal Insights in TBI Care—and How Urgent Care May Be Able to Help

Concerns over the lifetime consequences of head injuries have led to countless protocols and regulations for athletes and victims of accidents or falls. Advances are being made on the clinical front, too—some of which may light the way for urgent care to play a bigger role. First, a study just published in JAMA Network Open suggests that patients who presented to emergency rooms with what was ultimately found to be mild traumatic brain injury (mTBI) may not be receiving adequate follow-up care after discharge. Less than half the patients in that study received educational materials at discharge, and only 44% said they saw a healthcare provider for follow-up within 3 months, as is commonly recommended. This underscores the importance of assertive follow-up by the clinician and ensuring patients and caregivers understand the “next steps” they need to take. Another study, Potential to Reduce Unnecessary Emergency Department Referrals by Up to 75% Through Objective, Actionable Information for Mildly-Presenting Head Injured Patients in Urgent Care Centers Using BrainScope One, indicates that advancements in assessment tools may mean not all patients presenting with possible mTBI need to be referred to the ED as a matter of practice. It points out that most transfers from an urgent care center to the ED for imaging of patients suspected of having mTBI result in discharge and are ultimately considered unnecessary. Researchers looked at 196 patients enrolled in the BrainScope One Registry who were evaluated at 12 urgent care sites between June 2017 and April 2018. Their findings (71% of patients assessed were negative for mTBI, 21% were positive, and 8% needed further evaluation) led them to conclude that “urgent care centers have the potential to significantly impact on initial triage and assessment of mild head injured patients.” BrainScope One is an FDA-approved medical device that utilizes electroencephalogram technology for the objective assessment of the full spectrum of mTBI. (The current issue of JUCM includes several articles on the role urgent care centers can play in assessing and caring for patients who may have experienced mTBI.)