Professional Documents
Culture Documents
Clinic Team
Polytrauma and Traumatic Brain Injuries
March 07:
80 Polytrauma Support Clinic Teams,
50 Polytrauma Points of Contact
PTSD TBI
Attentional
problems
Headaches
Flashbacks
Depression
Dizziness
Insomnia
Nightmares
Irritability
Anxiety
Prevalence of Chronic Pain, PTSD and TBI
in a PNS clinic sample
Chronic PTSD
Pain N=232
N=277
16.5% 68.2%
81.5% 2.9%
10.3%
42.1%
12.6% 6.8%
TBI
5.3% N = 340
N=227
66.8%
Lew et al., (2009). Prevalence of Chronic Pain, Posttraumatic Stress Disorder and Post-
concussive Symptoms in OEF/OIF Veterans: The Polytrauma Clinical Triad. Journal of
Rehabilitation Research and Development, 46, 697-702.
PTSD
Pain
Re-experiencing
Avoidance
Social withdrawal
Memory gaps
Medication effects Apathy Altered Arousal
Pain Sensitive to noise
Concentration
Difficulty with decisions Insomnia
Mental slowness Irritability
Mild Concentration
TBI Headaches
Dizzy
Residua Appetite changes Substance
Fatigue
Sadness
Use (Poly)
Suicidality
Depression
PTSD Substance Use
Physical Injuries
Disorder
Re-Adjustment
Depression
Pain
Who are the OEF/OIF patients?
Vocational
Musculoskeletal Financial Challenges
Depression
Pain Stress
Deficits in
Social Role
Blast Exposure
Functioning
TBI
29
So what can be done to ameliorate symptoms
and encourage successful reintegration in
soldiers
Cognitive Physical
Rehabilitation
Occupational Social
Mental
RECOVERY CONTINUUM
Future Directions
• Research opportunities:
– Blast related conditions: diagnostic imaging, pathophysiology, etc.
– Polytrauma Pain
– Post traumatic headaches
– Sensory: Visual and hearing issues
– Advances in prosthetic devices
– Telehealth Rehabilitation initiatives
• Local:
– Zablocki VAMC Advanced Low Vision Outpatient Clinic
• National:
– New: VHA Interprofessional Polytrauma/TBI Rehabilitation Clinical
Fellowship
– New: VHA Amputation System of Care
– VHA PM&R Transitional Rehabilitation (PMRTR) program
– VHA TBI Specific Ocular Health and Visual Functioning Examinations
for Polytrauma Rehabilitation Center Patients
– Post Deployment Care Initiatives
Website resources
• vaww1.va.gov/rehab4veterans (VA PM&RS)
• www.biaw.org (Brain Injury Assoc. of Wisconsin)
• www.neuro.pmr.vcu.edu (National resource
Center for Traumatic Brain Injury)
• www.pdhealth.mil/TBI.asp (Deployment Health
Clinical Center (TBI)
• www.va.gov/health_benefits (VA Benefits)
• www.vetsuccess.gov (Voc Rehab and
Independent Living Services)