Guidelines for the Treatment of Severe Traumatic Brain Injury: Are They Used?

PACIFIC COAST SURGICALASSOCIATION Guidelines for the Treatment of Severe Traumatic Brain Injury: Are TheyUsed? Persons with severe traumatic brain injury (STBI) are frequently admitted to the neurologic intensive care unit. Each year, an estimated 1.4millionpeople in theUnited States have a TBI, resulting in 235 000 hospitalizations, 50 000 deaths, and $56.3 million in direct/indirect costs. Evidence-based guidelines for themanagementofpatientswithSTBIhavebeen available fromtheBrainTraumaFoundation (BTF) since 1995.1 Current recommendations, particularly those related to intracranialpressure (ICP),1 remaincontroversial owing to thequestions raised by single-center studies and international trials about thebenefit2-4 and feasibility5 of implementation. Based on a national assessment of US trauma medical directors (TMDs), the objective of our study was to determine the extent to which BTF guidelines are used.