Hospital Care Following a Head Injury

White, windowless, fluorescent-white blindness, buzzes and beeps, plastic chairs, feet rushing, people crying, people rejoicing, the smell of boiled food and fierce disinfectant.

If you’ve ever spent time in a hospital or been a regular visitor, it’s hard to forget those sights, sounds, and smells. They take you back to hours, weeks, or maybe months when fear was visceral, joy explosive, time stood still then blipped back in motion like a heart monitor after a miracle.

Hospital care after someone has a traumatic brain injury can run the gamut from a quick neurological checkup and perhaps an MRI imaging test to months of fulltime monitoring and care. Depending on the severity of the injury, hospital care might involve the emergency department and the intensive care unit.

When to go to the hospital

Whenever someone experiences a blow to the head — from a car crash, a sports injury, a fall ... anything — it’s smart to consider seeking medical help. But how do you know if a trip to the hospital is really necessary?

In a nutshell: when in doubt, go. Depending on the severity of the brain injury, going to the hospital can mean the difference between life and death. Here are a few convincing reasons why:

• The hospital is the only place that has a CAT scanner and MRI machine that can “look” inside your head and determine if there is any bleeding in your brain.
• Bleeding in the brain can be life-threatening when there is enough blood in the right spot to press down on the brain.
• If your brain is swelling, you may need surgery to save your life. That window of time can be small.

Caregivers: what do I need to know in the ER and the ICU?

Sometimes the decisions that need to be made about a loved one in the ER and ICU need to be made fast, especially if the TBI is severe or life-threatening. Here are some tips from other caregivers who have been there:

• Find out who’s in charge of your loved one’s care.
• Ask about what medications or procedures are being administered and why.
• Before signing anything, ask what exactly you are agreeing to and what consequences there will be if you do or you don’t sign. (For example, what are the risks of this surgery? What kinds of burdens or side effects will the proposed treatment impose?)
• Find an interpreter if you can’t speak English.
• Seek out a social worker. He or she can help during this tremendously emotional time and can also help you with your insurance company to retain a case worker to follow your medical case and work with you on financial coverage.
• Have friends and family share time with you in the hospital; you will need time to take care of yourself, too.
• If you're caring for a child, make sure you have put someone you trust in charge of taking care of your other children so that you and your spouse/partner can focus on your injured child.
• Don’t try to project what will happen in the next two weeks or two years — live and deal in the moment.

Staying longer

A person with TBI may stay in the hospital for months, until the medical staff deems him ready to move to a rehabilitation hospital or go home. Sometimes leaving the safety of the hospital with its 24/7 care can seem too early, frightening. However, these early referrals for an admission to an appropriate rehabilitation facility need to be made to ensure that arrangements are in place when the patient is ready for discharge from the acute care hospital. Next steps can be difficult, but with them come progress.