The Brain Trauma Foundation has developed the Guidelines for the Management of Severe Traumatic Brain Injury, first published in 1995 and revised twice, most recently in 2007. The foundation has also developed companion guidelines for pediatric TBI, prehospital management of TBI, early indicators and prognosis of severe TBI, surgical management of TBI, and field management for combat medics. The guidelines seek to create uniformity in TBI care all over the world.
An independent analysis of the effect of the Brain Trauma Foundation’s (BTF) guidelines on traumatic brain injury (TBI) outcome and cost savings by the Centers for Disease Control and Prevention (CDC) found that if the BTF guidelines were used more routinely, there would be a 50% decrease in deaths, improved quality of life and a savings of $262 million in annual medical costs, $43 million in annual rehabilitation costs and a lifetime societal cost of $3.84 billion.
The guidelines have been endorsed by the American Association of Neurological Surgeons, the World Health Organization Neurotrauma Committee, and the New York State Department of Health. The guidelines have been distributed to all neurosurgeons in the United States. The guidelines provide medical personnel a protocol which has been proven to improve the survival and outcomes of TBI patients and has been shown to reduce rates of mortality.
One of the main facets of the guidelines is the recommendation to monitor intracranial pressure in treating severe TBI patients. This process is called ICP Monitoring.
When the brain suffers severe trauma it begins to swell inside the skull. If the brain swelling goes undetected and is not treated the brain becomes deprived of oxygen-rich blood and "starves". This secondary injury causes permanent brain damage. With ICP Monitoring, which tells doctors how much swelling the brain has sustained and can drain cerebrospinal fluid, which would relieve some of the pressure, this outcome can be prevented.
In the United States surveys conducted in 1995, 2000 and 2006 have shown that since 1995 (the year the TBI Guidelines were published) ICP Monitoring rose from 32% to 78% in 2005.