Abstract
Traumatic brain injury (TBI) is a leading cause of death and disability in developed countries and in Ontario. Trauma is the primary cause of neurological injury contributing to disability and loss of productive years. Neurological assessment remains the cornerstone to identifying evolving injury and planning care. A comprehensive assessment including all components related to neurological function, such as Glasgow Coma Scale (GCS), pupillary size and light reactivity, limb strength and vital signs, is paramount if the nurse is to initiate prompt action by medical personnel meant to improve survival outcomes and minimize long term sequelae. Clinical surveillance is essential in the identification of physiological changes and is vital in deciding whether computerized tomography (CT) is necessary. This is especially important in regions where a return trip for diagnostic testing can extend the length of time in reaching a medical diagnosis and treatment.
 Recent studies have indicated gaps in the documentation of neurological assessment. Numerous studies have examined factors that influence patient outcomes following TBI, few have looked at the short term outcomes of immediate care for mild TBI and none could be found to suggest on-going clinical surveillance provided in the first six hours contributed to positive or negative outcomes.
Highlights
Le traumatisme cérébral (TC) est une des principales causes de décès et d'invalidité dans les pays développés et en Ontario
Traumatic brain injury (TBI) is a leading cause of death and disability in developed countries and trauma is the primary cause of neurological injury contributing to disability and loss of productive years (Canadian Institute for Health Information (CIHI), 2007a; Collie, 2009; World Health Organization (WHO), 1995)
The prevalence of TBI in Canada is estimated at 600 per 100,000 population and studies generally agree that 70-90% of all TBI are mild in severity with victims achieving full recovery in 3-12 months (Cassidy et al, 2004; Colantonio, 2016; Iverson, 2010; Ontario Neurotrauma Foundation, 2010)
Summary
Le traumatisme cérébral (TC) est une des principales causes de décès et d'invalidité dans les pays développés et en Ontario. De nombreuses études ont examiné les facteurs qui influent sur les résultats des patients à la suite d'un TC, peu ont examiné les résultats à court terme des soins immédiats pour le TBI léger et aucun ne pouvait suggérer que la surveillance clinique continue fournie dans les six premières heures a contribué aux résultats positifs ou négatifs. Despite the devastation of multiple injuries, a brain injury is the single most important determinant of a patient’s outcome (Stewart, Girotti, Nikore, & Williamson, 2003) from disability to death (Canadian Institute for Health Information (CIHI), 2006a, 2007a, 2007b; Dagher, Richard-Denis, Lamoureux, DeGuise, & Feyz, 2013; Ontario Neurotrauma Foundation, 2010). The aim of this paper is to review the available literature with preference to scholarly research, other sources of available data are considered for their contribution to completing a picture of TBI in northern Ontario, Canada provided that the sources contributed reliable and verifiable information
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