Review article
Guidelines for rehabilitation of patients with traumatic brain injury
Žarko BAKRAN
; Odjel za neurološku rehabilitaciju, Specijalna bolnica za medicinsku rehabilitaciju Krapinske Toplice, Krapinske Toplice
Tea SCHNURRER-LUKE-VRBANIĆ
; Zavod za fizikalnu i rehabilitacijsku medicinu, Klinički bolnički centar Rijeka, Rijeka
Mira KADOJIĆ
; Odjel za fizikalnu medicinu i rehabilitaciju Osijek, Klinički bolnički centar Osijek
Saša MOSLAVAC
; Spinalni odjel, Specijalna bolnica za medicinsku rehabilitaciju Varaždinske Toplice, Varaždinske Toplice
Tonko VLAK
; Zavod za fizikalnu medicinu, rehabilitaciju i reumatologiju, Klinički bolnički centar Split, Split
Simeon GRAZIO
; Klinika za reumatologiju, fizikalnu medicinu i rehabilitaciju, Klinički bolnički centar Sestre milosrdnice, Zagreb
Abstract
The consequences of traumatic brain injury (TBI) make for one of the most important health problems in Croatia. The most common cause for TBI is traffic accidents (70%), and at the time of obtaining TBI 22% of patients are under the influence of alcohol. Rehabilitation of persons with TBI in Croatia is implemented as a hospital, outpatient or rehabilitation at home. Rehabilitation of people with severe or moderate TBI for most patients is spent in the Special Hospital for Medical Rehabilitation Krapinske Toplice. During the rehabilitation patients are involved in the complex rehabilitation process with a multidisciplinary team and interdisciplinary team collaboration. The rehabilitation process is planned, recommended and regulated by a specialist in physical and rehabilitation medicine (PRM) in collaboration with members of the multidisciplinary team. Hospital rehabilitation team consists of a physician – PRM specialist, clinical psychologist, speech therapist, physiotherapist, occupational therapists, a nurse, and the patient who is, with his/her family, in the center of the rehabilitation process. Occasionally, if necessary other specialists join the team (e.g. neurologist, psychiatrist, neurosurgeon, specialist of internal medicine, radiologist, orthopedic surgeon, ophthalmologist), as well as a lawyer and/or social worker. Acute treatment of patients with severe TBI takes on average 100 days (for 85% of patients), hospital medical rehabilitation for these patients lasts on average 200 days for 70% of patients, 400 days for 20% of patients, and even longer for 10% of patients (6000-1000 days). Upon completion of the hospital’s medical rehabilitation in case of indications is recommended to continue outpatient rehabilitation, rehabilitation at home, or are placed in public or private institutions in which they have accommodation and essential nursing care. A PRM specialist or psychiatrist or neurologist recommends to the general practitioner to send patients for assessment of work capacity and sometimes determining a temporary or permanent guardian, most often an educated and responsible family member. If necessary, prior to discharge orthopedic devices required for better patient functioning, both at home and in the community, are ordered.
Keywords
guidelines; rehabilitation; traumatic brain injury
Hrčak ID:
163312
URI
Publication date:
14.3.2016.
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