Skip to main content

Military Health System

DOD warfighter brain health draft plan has six priorities

Image of Military medical personnel looking at a patient's brain scan. Lorie Falaminiano, an MRI technologist at Naval Medical Center San Diego, conducts a scan of a patient's brain Aug. 3. Brain scans that occur on a more frequent basis during a warfighter’s military career and beyond are one of the six concerns and priorities outlined by operational service members. (Photo by Navy Mass Communication Specialist Seaman Luke Cunningham.)

Recommended Content:

Traumatic Brain Injury Center of Excellence | Brain Injury Awareness To Improve Readiness | Brain Injury Awareness To Improve Readiness | Brain Injury Awareness To Improve Readiness | Brain Injury Awareness To Improve Readiness

Documenting how warfighters score on cognitive testing – from the beginning of their careers until after they leave military service – is one of six major concerns and priorities of service members being addressed in a plan for brain health that is in final draft form.

This change to looking at brain exposures and traumatic brain injury (TBI) across the warfighter’s entire career represents a “paradigm shift” in the Department of Defense’s approach, TBI specialist Kathy Lee told the Society of Trauma Nurses annual conference, held virtually March 26.

Lee, senior health policy analyst for DOD’s Health Affairs, discussed the comprehensive strategy and plan for warfighter brain health (WBH), which addresses brain health, brain exposures, including blast exposures, TBI, and long-term and late effects of exposures and/or TBI.

General physical and brain health assessments, scans, or tests “that occur on a more frequent basis over time across their military careers and beyond if deficits are identified” is one of the six concerns and priorities outlined by operational service members, according to Lee.

Dissemination of information on which “brain exposures are most damaging” and “outright disclosure if they are at increased risk of exposure or injury while performing a specific training activity” such as breaching walls or experiencing blast overpressure is another priority and concern for transparency.

There are “multiple, deleterious effects of exposures before traumatic brain injury actually occurs” as well as TBI itself, Lee said. Known and emerging brain exposures are: blast overpressure; blunt force/impact; projectiles; directed energy (high-powered microwave); chemical-biological toxins; and other environmental hazards, she explained.

Patient being prepped for a PET scan
Michelle Pribble, Naval Medical Center San Diego's lead nuclear medicine technologist, prepares a patient for a positron emission tomography (PET) scan in the hospital's Nuclear Medicine Department Oct. 6. A PET scan is used for revealing or evaluating conditions including brain disorders. (Photo by Navy Mass Communication Specialist Seaman Luke Cunningham.)

“Upwards of 86 percent of traumatic brain injuries are classified as mild” and are known as concussions, she said. “We can see 14,000 to 17,000 patient visits per month for TBI in the military health system, which is why we need standardized tools and research” to identify, control, and mitigate these brain exposures and TBIs.

The other four concerns expressed by service members are:

  • “Perceived disconnect” between operational efforts in preparation and training for combat and “medical communities translating brain health information to the service member in time to help them,” Lee said.
  • “Warrior mindset” that can discredit a service member’s own struggles or concerns “because they have a desire to complete their mission despite brain exposures, injury or illness” and “because they often compare themselves to other service members who may be in worse condition,” she said.
  • “Multiple concerns” over the newer emphasis on blast overpressure exposures and brain health and how safety and training changes may dilute training opportunities, deployment readiness and force lethality.
  • “Clinical tools, protocols, and research solutions” if the service member has been in the military longer and “may be noticing changes in functional abilities.”

All service members are required to take the Automated Neuropsychological Assessment Metrics test (ANAM) prior to deployment. The test has been in use since 2008 and has 10 domains to set up a baseline of cognition, which is one marker of brain health, Lee said.

“In fiscal 2019, we completed more than 220,000 of these assessments,” she said. “The WBH proposed plan will expand that requirement to include conducting the ANAM on all service members so that we can monitor and optimize cognitive performance and maximize combat effectiveness,” she said.

The WBH draft plan has 18 objectives and 53 associated activities along five “lines of effort” for “the deliberate, prioritized, and rapid development of end-to-end solutions,” Lee explained.

The five lines of effort are:

  • Optimize cognitive and physical performance
  • Identify, monitor, and mitigate brain exposures
  • Prevent, recognize, and minimize the effect of TBI
  • Reduce or eliminate long-term/late effects
  • Advance warfighter brain health science

The research and science objectives of the DOD plan are to “align brain health research and acquisition to current and emerging threats and operational requirements;” “maximize WBH research opportunities for partnerships with other government agencies, industry, and academia;” “enable researchers to have access to valid data regarding brain exposures and injuries and related brain health effects;” and “translate research findings into knowledge and materiel products, practice, and policies to maintain and optimize WBH,” Lee said.

Some of the research involves evaluating the late effects following blast and multiple TBIs by examining the brains of more than 200 service members from a repository at the Uniformed Services University of Health Sciences in Bethesda, Maryland, Lee noted.

Research includes examinations of clinical diagnoses, blood-based biomarkers, genetics, diagnostic imaging, and outcomes after treatment. A new rapid blood biomarker for TBI was cleared recently by the Food and Drug Administration for use in austere environments, adding to the armamentarium of biomarker tests.

The WBH plan is based on an Oct. 1, 2018, directive from DOD stating there should be a “single approach to brain health” in warfighters of all services that goes from brain exposure to TBI.

“Prior to this directive, there have been successful but disparate efforts,” Lee said.

The plan has been created through 18 months of field work and working groups, she noted. It is anticipated that the plan will be approved prior to the end of the fiscal year.

Her presentation was the first time the Society of Trauma Nurses had heard about the DOD plan, said society President Maria McMahon. It was noteworthy for practitioners because the DOD Warfighter Brain Health construct lends itself to nurse practitioner engagement in clinical practice, patient education, policy development, and emerging research.

Lee previously presented the data at December’s annual meeting of AMSUS, The Society of Federal Health Professionals, and the draft plan was part of a November 2020 themed issue of the Journal of the American Association of Nurse Practitioners.

You also may be interested in...

TBICoE 2021 Publications

Publication
3/16/2022

Master list of 2021 TBICoE articles published in research journals

Recommended Content:

Traumatic Brain Injury Center of Excellence | Patient and Family Resources | TBICoE Research | Traumatic Brain Injury Center of Excellence

A Retired Navy SEAL Discusses his TBI

Video
3/9/2022
A Retired Navy SEAL Discusses his TBI

Retired Navy SEAL Edward Rasmussen discusses his TBI, and urges others to seek treatment if they have symptoms. If you’re experiencing symptoms of TBI, visit health.mil/TBI to learn about the resources available to you.

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

One Airman's Recovery from TBI

Video
3/9/2022
One Airman's Recovery from TBI

After a motorcycle accident, Master Sergeant Stalnaker started having symptoms of traumatic brain injury, or TBI. He tells his story about his symptoms and his road to recovery from physical and emotional wounds as a result. If you’re experiencing symptoms of TBI, visit health.mil/TBI to learn about the resources available to you.

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

BIAM Heads Up

Infographic
2/17/2022
BIAM Heads Up

Head injuries, especially from a blast, have become one of the most common combat-related injuries among deployed service members. Typical head injury symptoms are: trouble hearing speech in noisy settings, ringing or other sounds in your ears or head, or dizziness when you move your head while walking or bending down. Talk to your doctor if you have any of these symptoms. For more about TBI and hearing loss, visit: https://hearing.health.mil/Resources/Education/Conditions-and-Concerns/TBI-and-Hearing-Loss #BIAMonth #BeTBIReady

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

Brain Injury Awareness Month Banner

Infographic
2/17/2022
Brain Injury Awareness Month Banner

March is Brain Injury Awareness Month. Traumatic brain injuries are a key health concern for the military community. Thanks to innovations across the Military Health System, we are improving quality of life for TBI patients & their families. This month, we will share stories, tips, and resources for TBI prevention and recovery. www.health.mil/BIAMonth #BeTBIReady #BIAMonth

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

BIAM Vision and Hearing

Infographic
2/17/2022
BIAM Vision and Hearing

Vision and hearing are vital senses for effective communication and situational awareness. To defend yourself against injury and maintain mission readiness, wear the proper vision and hearing protection while on and off duty. Find the latest vision and hearing protection recommendations here: • Vision: https://vce.health.mil/Eye-Injury-Prevention-and-Response/Eye-Protection • Hearing: https://hearing.health.mil/Prevention/Evaluated-Hearing-Protection-Devices #BIAMonth #BeTBIReady

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Vision and Hearing Loss Prevention

BIAM TBI 3

Infographic
2/17/2022
BIAM TBI 3

#DYK Symptoms of TBI aren’t just physical? Severe TBIs can increase the risk for mental health conditions, such as anxiety and depression. Learn more: https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/Patient-and-Family-Resources #BeTBIReady

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

Brain Injury Awareness Month 1

Infographic
2/17/2022
Brain Injury Awareness Month 1

Even a mild traumatic brain injury can impact mission readiness and the ability to deploy. #BeTBIReady by understanding the signs and symptoms of TBI, and knowing when to seek care. Thanks to innovations across the Military Health System, TBI is treatable & recovery is possible. www.Health.mil/BIAMonth #BIAMonth #BeTBIReady

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

BIAM Head Injury

Infographic
2/17/2022
BIAM Head Injury

DYK? If you sustain a head injury, you could also have vision, balance, and hearing damage problems. See your health care provider right away. https://vce.health.mil; https://hearing.health.mil #BIAMonth #BeTBIReady

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

BIAM TBI 2

Infographic
2/17/2022
BIAM TBI 2

#DYK Most TBIs experienced by service members are mild concussions? But, remember, even a mild TBI can impact your overall health and ability to deploy. Learn more: https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/Patient-and-Family-Resources #BeTBIReady

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

BIAM TBI

Infographic
2/17/2022
BIAM TBI

#DYK Most TBIs don’t occur while deployed? TBIs typically result from activities like sports, falls, or car accidents. Wearing protective gear is one way you can minimize your risk of TBI. #BeTBIReady https://www.health.mil/tbi

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

BIAM Providers

Infographic
2/17/2022
BIAM Providers

Providers: Stay up-to-date on the latest evidence-based clinical guidance and training so you are always #TBIReady. Visit: https://vce.health.mil/Clinicians-and-Researchers/Clinical-Practice-Recommendations, and https://hearing.health.mil/For-Providers. #BIAMonth #BeTBIReady

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

BIAM Call to Action

Infographic
2/17/2022
BIAM Call to Action

#PSA! Don’t forget your protective gear! Most TBIs do not occur in combat. They are usually caused by everyday activities like sports, training, or a car accident. You can minimize the risk of TBI by wearing protective gear. www.health.mil/BIAMonth #BeTBIReady #BIAMonth

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

BIAM Caregivers

Infographic
2/17/2022
BIAM Caregivers

#DYK? Family support helps TBI recovery? Learn how to support your loved one here: https://www.health.mil/News/Articles/2021/07/22/Caregiver-Guide-supports-service-members-and-veterans-with-TBI #BeTBIReady #BIAMonth

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

Brain Injury Awareness Month 2

Infographic
2/17/2022
Brain Injury Awareness Month 2

TBI symptoms aren’t just physical. Research shows traumatic brain injuries can lead to sleeping problems. Ignoring these problems can worsen symptoms and lead to longer recovery times. Learn more: www.health.mil/TBIproviders #BeTBIReady #BIAMonth

Recommended Content:

Brain Injury Awareness To Improve Readiness | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence
<< < 1 2 3 4 5  ... > >> 
Showing results 31 - 45 Page 3 of 17
Refine your search
Last Updated: December 07, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery