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The first 24 hours after a traumatic brain injury (TBI) can be scary. The patient's medical team will focus on the most urgent problems.

As a caregiver, you’ll want to ensure your loved one is receiving care from a medical center that can appropriately manage the severity of the injuries.

With traumatic brain injury, there are often other injuries to be treated besides the brain (broken bones, wounds, etc.), which the medical center will be monitoring and treating as well.

Other typical activities in the first 24 hours of a moderate to severe injury can include:

  • Monitoring and relieving pressure on the brain (elevating head of the bed, sedation as needed, using a brace if needed, etc.)
  • Initiation of feeding as early caloric intake can help improve outcomes
  • Monitoring for evidence of seizures
  • Monitoring lab work; Imaging and other diagnostic testing
  • Frequent neurological assessments (usually every 1-2 hours, depending on various factors)
  • Monitoring vital signs
  • Administering medications to reduce swelling and prevent seizures

For more mild injuries, the focus will be on assessment, imaging, and other monitoring to ensure the appropriate level of care is taking place. 

Once the patient has been stabilized and the “step-down” process begins, it may feel as if your loved one is actually receiving less care.

The good news, though, is that this is usually a promising step towards recovery and a sign that the patient is improving. You’ll continue to communicate with the medical center staff about the patient’s current status and next steps. 

During this time, it is important for family members and caregivers to rest and take breaks from the bedside. While it is normal to be in shock and feel worried about your loved one, recovery could take months or years, so it is important to stay mentally and physically healthy. Talk with other loved ones and start developing a supportive system of care that will be sustainable for the long-term.

Additionally, as a family member or other caretaker, you are an active member of your loved one's care team. As such, take time to educate yourself on the injury and research rehabilitation centers and other agencies that may be necessary down the road. Most importantly, don't be afraid to ask questions!

Time is brain. The quicker the patient gets to us the quicker we can start the healing process.
Dr. Oscar Guillamondegui, MD, MPH
Chief of Trauma and Acute Care Surgery
Vanderbilt University Medical Center, Level 1 Trauma Center

The Brain Injury Association of Tennessee (BIAT) is an awareness and advocacy organization dedicated to improving the lives of TBI survivors and their caregivers.

BIAT does not provide medical diagnoses, treatments, or advice. All medical treatments should be discussed with your provider.