Care for combat wounded service members is accomplished through a medical transport system which begins on the battlefield with initial life saving treatment. It continues through combat support hospitals and regional medical centers, then ultimately to the continental United States (CONUS). While the wounded service member is at U.S. medical centers, acute care intensifies with further medical stabilization and supportive TBI care. From start to finish, there is a rapid sequence of events that ensures timely identification and treatment of injuries. Though the medical assets at each level of care are different, the goal for all patients with traumatic brain injury is the same: to optimize outcomes.
Service members who sustain moderate to severe TBI while deployed are given emergency treatment at military facilities in theater. Once stabilized, the service member is transported to Landstuhl Regional Medical Center (LRMC) by United States Air Force (USAF) critical care transport teams. At LRMC, there is a full complement of medical professionals who provide round-the-clock care to injured service members. Commonly, trauma surgery, neurosurgery, neurology, and critical care doctors and nurses implement treatment plans according to military TBI care guidelines. This may involve additional medical stabilization, imaging and procedures. If needed, specialists such as orthopedists, plastic surgeons and others may be consulted.
The injured service member may undergo testing to help determine if symptoms are related to a TBI or another condition. Treatment for TBI-related symptoms, such as headaches, is started. If it is determined that complicated or prolonged TBI treatment is needed, arrangements are made for stateside transfer to one of the designated inpatient TBI centers: Walter Reed National Military Medical Center in Bethesda, Md., or Brooke Army Medical Center in San Antonio, Texas. This cycle of evacuation can occur in as few as 72 hours — much more quickly than in previous conflicts which sometimes took 30 days or more.
As is done with more severe injuries, patients with concussion are transported via the USAF aeromedical evacuation program. Those with concussion generally do not require inpatient medical services. As a result, they may be evacuated to their home duty station if the local military treatment facility has adequate TBI resources. In the event the home duty station does not have appropriate TBI assets, the service member is transferred to a stateside location that does. Service members may be referred to medical facilities hosted by another branch of service if needed.