This site is intended as a resource for those affected by polytrauma and blast-related injuries
including veterans, their caregivers and families; clinicians; and researchers.
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Center Mission
The mission of the Polytrauma and Blast-Related Injuries (PT/BRI) QUERI
Coordinating Center is to promote the successful rehabilitation,
psychological adjustment and community re-integration of individuals who
have experienced polytrauma and blast-related injuries.
The mission of the Polytrauma and Blast-Related Injuries (PT/BRI) QUERI is to
promote the successful rehabilitation, psychological adjustment and community
re-integration of individuals who have polytrauma and blast-related injuries.
The scope of the PT/BRI QUERI includes the full range of health problems, health
care system and psychosocial factors represented in this mission. However, PT/BRI
QUERI focuses on filling gaps and implementing research to improve health outcomes
for two high priority and prevalent blast-related injuries that occur in the
context of other combat injuries: Traumatic Brain Injury (TBI) and traumatic
amputation.
In this era of modern warfare, America’s Armed forces are sustaining new and complex
injuries – the majority of which are blast-related. In combat, sources of blast
injury include improvised explosive devices (IEDs), artillery, rocket and mortar
shells, mines, booby traps, aerial bombs and rocket propelled grenades. By the end
of March, 2007, 23,407 service members have sustained non-mortal injuries in the
wars in Iraq and Afghanistan, nearly one half of whom did not return to duty within
72 hours, presumably because of the severity of their injuries. The severity and
pattern of blast injuries depends on the explosive composition and amount of material
involved, the surrounding environment, delivery method, distance between the victim
and the blast, and the presence of intervening protective barriers or environmental
hazards. Due to improvements in body armor and field trauma care, more individuals
are surviving beyond the acute phase of these injuries. Consequently, the military
and VA are providing medical care to injured individuals who might have died in
previous conflicts.
Given the possible effects of explosions on the human body, it is not surprising that
blast injuries are often “polytraumatic.” Injured body systems and structures include
auditory/vestibular, eye, orbit, face, respiratory, digestive, circulatory, central
nervous system, renal/urinary tract, extremity, soft tissue, mental health, and pain.
Particularly common is Traumatic Brain Injury (TBI). It has been estimated that over
60% of blast-injuries result in TBI and TBI has been labeled the "signature injury" in
the Global War on Terror (GWOT). Consequently, best practice for polytrauma requires
a focus on TBI in the context of other injuries.
Based on Needs Assessment Studies, input from Executive Committee members and VA senior
staff, the Polytrauma and Blast-Related Injuries (PT/BRI) QUERI has identified four
priorities areas for research – (1) the development of data systems for tracking
patients and monitoring health care services needs and patient outcomes, (2) the
development of tools and strategies for maximizing care coordination as combat injured
patients navigate within and across care systems, (3) the development of interventions
and tools to support family members who find themselves in care-giving roles and to
facilitate their meaningful involvement in the recovery process, and (4) screening
and evaluation for high prevalent co-morbidities. PT/BRI QUERI investigators are
working on projects to improve outcomes in each of these high priority areas.
For site additions, edits or suggestions, please contact
Nina Sayer.