Care of the patient with mild traumatic brain injury.
Subject: Sports injuries (Care and treatment)
Sports injuries (Prevention)
Brain (Concussion)
Brain (Care and treatment)
Brain (Prevention)
Practice guidelines (Medicine)
Nursing care
Authors: West, Therese A.
Bergman, Karen
Biggins, Mary Susan
French, Brenda
Galletly, Julia
Hinkle, Janice L.
Morris, Jacquelyn
Pub Date: 08/01/2011
Publication: Name: Journal of Neuroscience Nursing Publisher: American Association of Neuroscience Nurses Audience: Professional Format: Magazine/Journal Subject: Health care industry Copyright: COPYRIGHT 2011 American Association of Neuroscience Nurses ISSN: 0888-0395
Issue: Date: August, 2011 Source Volume: 43 Source Issue: 4
Accession Number: 263250562
Full Text: ABSTRACT: Traumatic brain injury is a leading cause of disability worldwide. This clinical practice guideline was jointly developed by the American Association of Neuroscience Nurses and the Association of Rehabilitation Nurses. The purpose of this document is to provide recommendations based on current evidence that will help registered nurses, advanced practice nurses, and institutions provide safe and effective care to injured patients with a mild traumatic brain injury across the continuum of care. Included in the guideline are strategies for prevention and recommendations relevant to sport-related concussion and military populations.


Between 1 and 1.5 million emergency department visits occur in the United States annually for traumatic brain injury (TBI), and more than 75% of these are classified as mild. An estimated 300,000 sports-related concussions occur annually in the United States. In addition, the incidence of clinician-confirmed TBI in U.S. soldiers returning from Iraq/Afghanistan is reported to be in the range of 23%, the majority of which are mild. Thus, mild TBI is a significant problem and, as a leading cause of disability worldwide, is an important patient population for the provision of evidence-based nursing care to optimize outcomes. For the purposes of this guideline, mild TBI and concussion are used synonymously. In the development of the guideline, a computerized search of Medline, Cochrane, EMBASE, and the Cumulative Index to Nursing and Allied Health Literature was performed using mild head injury, mild traumatic brain injury, and concussion as keywords. The search was restricted to works in English published from 2005 to November 2010. The reference lists of identified articles were also searched for additional, relevant references, including books, guidelines, and articles. Background information is provided on epidemiology, pathophysiology of injury, and age-related differences. A panel of nursing experts developed recommendations for practice based upon the quality of available supporting evidence. Recommendations for nursing activities related to prevention, assessment, acute symptom management, rehabilitation, management of chronic problems, and patient/family education are provided. Included in the guideline are resources for clinicians and resources for patients and families. The complete guideline is available as Supplemental Digital Content, at

Therese A. West, MSN APN C; Karen Bergman, RN PhDc CNRN; Mary Susan Biggins, RN BSN MBA CRRN; Brenda French, MSN CRRN CBIS; Julia Galletly, MS ACNP-BC CCRN; Janice L. Hinkle, PhD RN CNRN; Jacquelyn Morris, RN BSN CRRN LNC CNLCP

DOI: 10.1097/JNN.0b013e3182160725

Questions or comments about this article may be directed to Hilaire Thompson, PhD RN CNRN FAAN, at She is the editor of the AANN Clinical Practice Guideline Series.

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