care following traumatic brain injury · a disruption of brain function resulting from a blow or...
TRANSCRIPT
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Care Following Traumatic Brain Injury
Military and Veterans Affairs Resources in NC
CDR Scott Klimp, USPHS
16 October 2014
Unclassified
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Introduction
Military and VA Resources in NC
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 3 of 24
Disclaimer
• The views presented herein are those of the presenter
and do not reflect the official policy of the Department of
the Army, Department of Defense, or the U.S.
Government.
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 4 of 24
- Traumatic Brain Injury (TBI) is a disruption of brain
function resulting from a blow or jolt to the head or a
penetrating head injury
- Categorized as mild (mTBI), moderate, severe or
penetrating
- The majority of TBIs in the DoD are mTBI, also known as
concussion
- Most individuals who sustain a concussion recovery fully
and quickly
- Symptoms may be physical, cognitive and/or behavioral
Background
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 5 of 24
DoD Definition of Traumatic Brain Injury (TBI)
OSD/HA MEMO OCT 1, 2007
A disruption of brain function resulting from a blow or jolt to the
head or a penetrating head injury indicated by new onset or
worsening of at least one of the following:
Loss of consciousness (LOC)
Post-traumatic amnesia (PTA)
• Loss of memory for events immediately before or after injury
Alteration of consciousness (AOC)
• Change in mental status at the time of injury such as confused, disoriented,
or slow thinking
Neurological deficits that may or may not be temporary
• Weakness, loss of balance, change in vision, paralysis, etc.
Intracranial lesion
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Scope of TBI across DoD
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 7 of 24
TBI in DoD 2000-2013
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 8 of 24
Incidence by Service
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 9 of 24
Incidence by Severity
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Army
Military and VA Resources in NC
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 11 of 24
• Goal: A cultural change following
concussive events
• Vision: Every Warrior treated
appropriately to minimize concussive
injury and maximize recovery
• Mission: Produce an educated force
trained and prepared to provide
early recognition, treatment &
tracking of concussive injuries in
order to protect Warrior health
Department of the Army Concussion/mTBI Strategy
Education &
Prevention
Early
Detection
Tracking
& Treatment
Rehabilitation,
Recovery &
Reintegration
Educate Train Treat Track
Image courtesy of OTSG
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 12 of 24
• Concussion Care Clinic (acute injury)
– Patient education and immediate symptom management
• Comprehensive Brain Injury Team (chronic symptoms)
– Multidisciplinary evaluations including medical, neuropsychological,
psychological, physical therapy/vestibular, neuro-optometry,
occupational therapy
• Intrepid Spirit (National Intrepid Center of Excellence satellite)
– Projected opening Fall 2015
– Integrated care for complex patients involving TBI, behavioral health
and pain
Department of Brain Injury Medicine
Womack Army Medical Center, Ft. Bragg
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 13 of 24
Mission and Vision
Mission: Through the establishment of a new care model including enhanced case management, an arena intake and an intensive outpatient rehabilitation, the Intrepid Spirits will:
provide evidence-based interdisciplinary
assessment and intensive outpatient care
for SMs with complex medical conditions
with the goal of fostering optimal
outcomes.
Vision: To lead the nation and set the
definitive standard for the provision of
interdisciplinary, integrated, and holistic
assessment and intensive outpatient healthcare
for SMs with complex medical conditions, including
TBI, trauma related disorders, PTSD and other mood disorders, chronic pain, and related conditions.
Chronic
Pain
PTSD/
BH
TBI
Substance
Use
Disorders
Family &
Spiritual Support
Rehabilitation
Other MTF
Capabilities
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 14 of 24
• Screening and administrative services
– Annual training (Soldiers and healthcare providers)
– Post-deployment assessments and screening
– Open access
– Integrated disability evaluation system with VA
Department of Brain Injury Medicine
Womack Army Medical Center, Ft. Bragg
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Department of the Navy/
United States Marine Corps
Military and VA Resources in NC
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 16 of 24
• NICOE Intrepid Spirit Concussion Recovery Center
– Opened 2013
– Acute care of mTBI
– Multidisciplinary evaluation and treatment of chronic
mTBI-related symptoms
Naval Hospital Camp Lejeune
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United States Air Force
Military and VA Resources in NC
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 18 of 24
• 4th Medical Group
– Primary Care Services
– Mental Health Services
– Behavioral Health Optimization Program
– Civilian care under TRICARE
Seymour Johnson Air Force Base
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Department of Veterans Affairs
Military and VA Resources in NC
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 20 of 24
• Acute and chronic care services
• Strong nationwide network for intensive rehab
services
• Rehabilitation services
• Vocational Rehabilitation and Employment services
Department of Veterans Affairs
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Partners
Military and VA Resources in NC
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16-Oct-14 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address CDR Scott Klimp/(910) 907-7917/[email protected] 16 October 2014 Slide 22 of 24
• UNC Medical Center/ civilian trauma centers
• Defense Centers of Excellence for TBI/Psychological
Health (DCOE)
• Defense and Veterans Brain Injury Center (DVBIC)
• National Intrepid Center of Excellence (NICoE)
• Brain Injury Association of North Carolina
Partners
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Summary
Military and VA Resources in NC
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Questions