Promoting Recovery in Children Who Sustain a Mild Traumatic Brain Injury: The TBI Evaluation and Management (TEaM) Toolkit

项目摘要 在美国，据估计，每年有超过380万例创伤性脑损伤（TBI）， 每年约有250万次急诊。对于14岁以下的儿童， 2013年，约有640，000例TBI相关急诊（艾德）就诊[CDC 2018年]。超过80%的TBI被归类为轻度（mTBI），术语脑震荡可互换使用[McCrory 例如，2017; Menon等人，2010]。除了急诊室，紧急护理中心和初级保健医生也 负责对寻求mTBI护理的患者进行初步评估和管理。尽管是良性的 听起来，mTBI通常具有显着的短期和长期后果，可以通过早期治疗来改变。 识别、干预和管理（Yang等人，2017;柯林斯等人，2016）。然而， 护理是分散的，临床医生在适当的评估，护理和管理的协调培训， 有限公司为了克服这些局限性，本研究的主要目的是证明证据- 基于实践和教育的病人，照顾者，临床提供者和学校是可行的， 将促进儿童和青少年轻度TBI后的恢复。我们已经开发了一个 基于证据/最佳做法的TBI评价和管理工具包， mTBI医疗系统。TEaM工具包利用电子病历系统（eMR）和 有针对性的培训计划，以改善整个连续体的筛选，管理和联系，或者什么 我们称之为护理社区，目标是制作一个有效的和可扩展的工具包， 复苏 !

PROJECT SUMMARY In the US, it is estimated that there are over 3.8 million traumatic brain injuries (TBI) annually, which account for approximately 2.5 million emergency department visits each year. For children 14 years of age and younger, there were approximately 640,000 TBI-related emergency department (ED) visits in 2013 [CDC 2018]. Over 80% of TBI is classified as mild (mTBI), with the term concussion used interchangeably [McCrory et al., 2017; Menon et al., 2010]. In addition to EDs, urgent care centers and primary care physicians are also charged with the initial evaluation and management of patients seeking care for mTBI. Despite the benign sounding term, mTBI often has significant short and long-term consequences that can be modified by early identification, intervention and management (Yang et al., 2017; Collins et al., 2016). However, the system of care is fragmented and clinician training on appropriate evaluation, coordination of care and management is limited. To overcome these limitations, the primary aim of this study is to demonstrate that evidence- based practice and education for the patient, caregivers, clinical providers and schools is feasible and will promote recovery following a mild TBI in children and adolescents. We have developed an evidence/best-practices based TBI Evaluation and Management (TEaM) Toolkit aimed at key providers in the system of mTBI healthcare. The TEaM Toolkit leverages the electronic medical record system (eMR) and a targeted training program to improve screening, management, and linkage throughout the continuum, or what we refer to as the neighborhood of care, with a goal of producing an effective and scalable toolkit to promote recovery. !