The work of the Centers for Disease Control and Prevention, within the U.S. Department of Health & Human Services is examined here, with a special focus on traumatic brain injury
Centers for Disease Control and Prevention (CDC) is a major part of the U.S. Department of Health & Human Services. We know that they work 24 hours a day, seven days a week to “protect America from health, safety and security threats, both foreign and in the U.S.”
Whether diseases start in the U.S. or not, are curable or preventable, chronic or acute, of human error or deliberate attack, CDC aims to tackle disease and support citizens and communities in this vein.1 It’s amazing to look at just how many diseases and conditions are covered by the work of the CDC, such as asthma, which at the time of writing is highlighted as the disease of the week on the organisation’s website.2 The most searched diseases & conditions on CDC’s website are vast and include autism, cancer, diabetes, epilepsy, ﬂu (inﬂuenza), hepatitis, HIV/AIDS, meningitis, stroke and traumatic brain injury (TBI).3
Traumatic brain injury (TBI)
This article will now turn to focus on one of these areas, TBI. In the view of CDC, TBI can be deﬁned as “a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.”
People of all ages are at risk from TBI, particularly children and older adults.4 We know that TBI is a concerning public health problem in the U.S. today. Annually, TBI results in a signiﬁcant number of cases of permanent disability and deaths.
Certainly, in 2014, there were around 2.87 million TBI related hospitalisations, emergency department visits and deaths in the U.S. No less than 837,000 of these health events are among children. Also, TBI may range from “mild” (a brief change in consciousness) or mental status) to “severe” (an extended period of unconsciousness or amnesia following the injury). As such, the research and programs of CDC aim to prevent TBI and help us to better recognise, respond and recover in the event of TBI taking place.5
When it comes to TBI-related emergency department visits, hospitalisations and deaths (EDHDs), we know that during 2014, around 2.87 million TBI-EDHDs took place in the U.S., including over 837,000 among children as mentioned earlier.
The key ﬁndings were as follows:
• Something in the region of 2.53 million TBI-related ED visits took place, 812,00 of which occurred among children.
• There were around 288,000 TBI-related hospitalisations, 23,000 of which were children.
• Unfortunately, CDC says there were around 56,800 TBI-related deaths, 2,529 of which were among children.6
When it comes to TBI-related emergency department (ED) visits, we ﬁnd out further details about this from the CDC, which include the following, but you can ﬁnd out more about trends in age-adjusted rates of TBI-related emergency department visits on the website of CDC.
“Unintentional falls, being unintentionally struck by or against an object, and motor vehicle crashes were the most common mechanisms of injury contributing to a TBI diagnosis in the ED. These three principal mechanisms of injury accounted for 47.9%, 17.1%, and 13.2%, respectively, of all TBI-related ED visits.
“Rates of TBI-related ED visits per 100,000 population were highest among older adults aged ≥ 75 years (1,682.0), young children aged 0-4 years (1,618.6), and individuals 15-24 years (1,010.1).”7
The symptoms of TBI?
So, we’ve looked a selection of key TBI statistics but what are the symptoms of the disease? The good news here is the majority with a TBI “recover well from symptoms experienced at the time of the injury.” While most TBIs are mild, for some, symptoms are endured for days, weeks, or longer.
Generally speaking, recovery can be slower among older adults, teenagers and young children. Unfortunately, people who have had a TBI during the past are at risk of having another one. It is true to say that some people ﬁnd it takes longer to recover if they have another TBI.
Symptoms usually fall into four categories, and you can ﬁnd out more information about these here. Some of the symptoms include diﬃculty thinking clearly, a headache and fuzzy or blurry vision, irritability and sleeping more than usual. It is worth mentioning that some of these symptoms show up straight away but others do not arise for days or even months following the injury. Danger signs in adults include – weakness, numbness or decreased coordination; repeated vomiting or nausea; slurred speech; looking very drowsy or not able to wake up, having convulsions or seizures, not recognising people or places; and becoming increasingly confused, restless, or agitated.8
Treating children with mild traumatic brain injury (mTBI) In September 2018, the CDC released new clinical recommendations for healthcare providers treating children with mild traumatic brain injury (mTBI), also referred to as concussion. This is an excellent example of how the CDC works continuously to protect the U.S. from health, safety and security threats, in the country and farther aﬁeld.9 Debra Houry, MD, MPH, Director of the National Center for Injury Prevention and Control (NCIPC) at CDC10 commented about these recommendations and stressed the importance of evidence-based guideline in the U.S. concerning pediatric mTBI, which is a good point to end this article on.
“More than 800,000 children seek care for TBI in U.S. emergency departments each year, and until today, there was no evidence-based guideline in the United States on pediatric mTBI –inclusive of all causes.
“Healthcare providers will now be equipped with the knowledge and tools they need to ensure the best outcomes for their young patients who sustain an mTBI.
“We have heard from healthcare providers that they want and need consistent, current, and evidence-based guidance for diagnosing and managing mTBI. And this guideline can help. However, we also designed the guideline so it can help inform eﬀorts aimed at supporting families, sports coaches, and schools –who are all integral to keeping children safe and healthy.”11