Army Task Force Finds Gaps In Brain-Injury Care

Team Infidel

Forum Spin Doctor
USA Today
January 18, 2008
Pg. 7
But improvements made to identify, treat victims of wars' signature wound
By Gregg Zoroya, USA Today
An Army task force found major gaps in the care of traumatic brain injury last year, but officials say they are moving rapidly to correct the problems.
A task force study-- completed last May but not made public until Thursday-- found fault with several issues, including efforts to identify and treat soldiers suffering mild traumatic brain injury often resulting from exposure to roadside bomb blasts.
Although victims often show no outward sign of the injury, it can affect brain functions dealing with short-term memory, problem solving and sleep, and cause nausea, dizziness and headaches. Treatment often involves pulling a soldier out of combat temporarily or permanently, and treating the symptoms.
Screening efforts show 10% to 20% of Marines and soldiers returning from Afghanistan and Iraq may have suffered this wound, according to the Army. The task force last May found that "major gaps" in identifying and treating the injury "were created by a lack of coordination and policy-driven approaches."
This was despite the fact that researchers at the Defense and Veterans Brain Injury Center-- the Pentagon's premier clinical research office for brain injury-- had developed ways of identifying the wound in 2004, the study said.
USA TODAY reported in November that at least 20,000 U.S. servicemembers returning from combat have been diagnosed with, or shown signs of, brain injury.
"There is clearly a problem when the most common injury of the war is the least understood," said Sen. Patty Murray, D-Wash. "This task force is a long-overdue step forward in diagnosing and understanding the signature wound of this war."
In a news conference Thursday, the task force's chairman, Brig. Gen. Donald Bradshaw, lauded the Army's efforts to improve care in recent months. Not only are soldiers screened for brain injury immediately after exposure to blasts, they are screened again as they come home, Bradshaw said. Computer-based cognitive testing that provides a better understanding of the brain damage have been introduced into the war zone and at military installations. Standard guidelines for treating brain injury were completed in October.
"Since the release of the report (in May) we've been working arduously to put these recommendations into action," said Col. Judith Ruiz, a task force member and program manager for traumatic brain injury.
The task force applauded the brain-injury program at Fort Carson, Colo., where 17% of returning soldiers have shown signs of the injury. As a result, the Army is replicating Fort Carson's program at other installations.
The task force said most soldiers suffering mild brain injury recover completely. Army Col. Robert Labutta, a neurologist and member of the task force, added that research is underway to determine long-term effects.
Out of 48 task force recommendations in May to improve the diagnosis, treatment and research into brain injury, nine have been implemented, and 31 are being addressed.
"This is a very complex process and so the fact that we've made headway on all of these recommendations is really very, I think, laudatory," Bradshaw said. Most important, he said, the Army has moved aggressively to educate soldiers, commanders and medics in the field about mild traumatic brain injury, how to identify it and take steps to have it treated.
Task force recommendations still to be addressed include:
*Better ways of tracking the incidents of brain injury, and identifying former soldiers who may have suffered a brain injury, but left the service. An estimated 1.5 million servicemembers have served in the current conflicts in Iraq and Afghanistan.
*Broader baseline testing of a soldier's brain functions before he or she goes into combat so deficits can later be gauged accurately. This specialized computer-based testing has already been given to 40,000 servicemembers.
*Standardizing the care and treatment of brain-injured soldiers at all Army medical hospitals.