PT  - JOURNAL ARTICLE
AU  - Derick T Wade
AU  - Meenakshi Nayar
AU  - Javvad Haider
TI  - Management of traumatic brain injury: practical development of a recent proposal
AID  - 10.7861/clinmed.2021-0719
DP  - 2022 Jul 01
TA  - Clinical Medicine
PG  - 353--357
VI  - 22
IP  - 4
4099  - http://www.rcpjournals.org/content/22/4/353.short
4100  - http://www.rcpjournals.org/content/22/4/353.full
SO  - Clin Med2022 Jul 01; 22
AB  - A recent article identified weaknesses in the management of patients with traumatic brain injury (TBI). The authors suggested some reasons but overlooked two of the reasons for the low quality of services: a lack of resources and a systemic failure to organise rehabilitation services. They suggested early involvement of a condition-specific service with a new ‘neuroscience clinician’ and additional neuro-navigators, but the evidence shows this approach does not work. Their proposal failed to acknowledge the neuroscience skills of existing rehabilitation medicine consultants and teams, and ignored the many non-TBI problems patients will have and the consequent need for expert rehabilitation input. We revise and develop their proposal, suggesting an alternative way to improve services. Rehabilitation teams should work in parallel with acute services and remain responsible for the rehabilitation of patients as they move through different settings. This suggested development of rehabilitation mirrors the development followed by geriatric medicine from 40 years ago.