Traumatic Head Injury: Guide to Care Options - Part 1

Care options for individuals who have experienced a traumatic head injury may seem wide-ranging and complex.

As the period following any serious injury can be very difficult for the individual in question, as well as their family and friends, accessing the right care services to ensure the best head injury treatment that one is entitled to can be a challenging time.

Our care options series details personal injury treatment and options available for individuals and their families who have experienced a traumatic head injury.

• Part 1 – Emergency & Hospital Head Injury Treatment
• Part 2 – Post-Hospital Head Injury Rehab & Funding
• Part 3 – Brain Injury Support in the Community
• Part 4 – Care Navigators & Returning to Work after Brain Injury
• Part 5 – The Importance of Sleep after Head Injury
• Part 6 – Brain Injury Support & Financial Assistance
• Part 7 – Long Term Effects Of Head Injury
• Part 8 – Assistive Technology for Traumatic Brain Injury

For further information please see our Serious Injury homepage.

Acute/Emergency traumatic head injury treatment

Initial traumatic head injury treatment can vary widely depending upon a person’s injury and their location at the time the injury occurred.

A paramedic may be needed to stabilise the person, checking their breathing, stopping any bleeding, ensuring they are safe to be moved and making the person as comfortable as possible.

If a traumatic head injury is of a certain severity the person will be taken to the closest major trauma centre. There are two major trauma centres in the North East, The Royal Victoria Infirmary in Newcastle and James Cook University Hospital in Middlesbrough. Both hospitals have facilities for a helicopter to bring patients into the hospitals.

When all the various checks have been made a person will be moved to hospital for further observation.

Once stable a computer tomography (CT) scan may be carried out to detect the level of serious injury sustained. The extent of a brain injury may be assessed using the Glasgow Coma Scale, which is numbered from 3 to 15, the latter being the most severe.

Depending on what is found by the CT scan, a person may require surgery on their head and/or brain.

Intensive care & high dependency units

Following surgery, an individual may need to spend some time in an intensive care unit (ICU) or high-dependency unit (HDU) as the next step in traumatic head injury treatment.

The HDU is a bridge between an ICU and general ward, for patients who require more than regular observation but not as much as in an ICU. Timescales in each unit, and then on a general ward, can vary widely depending on a person’s individual circumstances.

An occupational therapist (OT) will usually monitor a person daily from the moment a person regains consciousness.

As people often display signs of post-traumatic amnesia (PTA) following a brain injury, an OT may monitor a person until they show signs of recovery for several days in a row.

PTA is an individual thing, but can include memory loss, confusion, restlessness and uncharacteristic behaviour. Signs of recovery may include them displaying an ability to learn new things and be able to discuss recent events without memory lapses.

Once an individual has been assessed as stable, rehabilitation sessions may be introduced, which an OT may continue to be involved in.

The type of rehab involved will be patient-specific, and may include speech and language therapy, neuro psychology and physiotherapy, alongside work with doctors and nurses.

A person may also benefit from a consultation from a social worker and/or a dietician.

Step down

The time that hospital head injury treatment may take is patient specific, and may last days, weeks, a number of months or even years.

Once hospital rehabilitation is complete, a person may be transferred to a Step Down Unit in order to continue with their recovery.

A Step Down is a bridge between hospital and home, with a long-term aim to equip an individual to be able to live in the wider community again.

For more information, please see our section on Post-Hospital Head Injury Rehab & Funding in Traumatic Head Injury: Guide to Care Options – Part 2.