Welcome to the ERABI Clinical Guidebook!
The ERABI Clinical Guidebook is intended to be a learning resource for residents and a useful complement to ERABI modules. The Clinical Guidebook represents the intersection of available relevant ABI literature, and clinically relevant best practices and procedures.
The Guidebook is not intended to be a prescriptive or exhaustive list of treatment options for individuals with ABI. Given that there are other approaches to care available, clinical judgment should always be used when deciding the best course of treatment for a patient.
The ERABI Clinical Guidebook has been developed through extensive collaboration with clinical experts, researchers, the Ontario Neurotrauma Foundation, St. Joseph’s Healthcare London, the Lawson Health Research Institute, Western University, and our partners in Toronto and Ottawa.
Help us improve upcoming Clinical Guidebook chapters by providing us with feedback HERE or at email@example.com
Chapter 1. Introduction to Acquired Brain Injury (ABI)
This chapter covers defining and grading ABIs as well common mechanisms of injury and the types of neuronal injury that occur with an ABI. A brief summary on disorders of consciousness and post-traumatic amnesia is also included.
Chapter 2. Cognition and Cognitive-Communication Following Acquired Brain Injury
In this chapter the clinical presentation of cognitive and cognitive-communication deficits is discussed as well as their criteria for diagnosis. Relevant outcome measures are highlighted along with interventions for each area of cognition and cognitive-communication such as attention, memory, executive function, and cognitive-communication. A unique element of this chapter is that it features clinical algorithms from the INCOG Recommendations for Management of Cognition Following Traumatic Brain Injury group.
Chapter 3. Dysphagia, Aspiration, and Nutrition Post Acquired Brain Injury
This chapter covers the clinical presentation, incidence, and risk factors for dysphagia and aspiration. Instrumental outcome measures and assessments are discussed along with the criteria for diagnosis. Relevant interventions are highlighted, including those from the Stroke Best Practice Guidelines for Managing Dysphagia. The importance of oral care and nutritional management, as well as evidence-based interventions, are also discussed.
Chapter 4. Pediatric Acquired Brain Injury Acute Care and Rehabilitation Interventions
This guidebook chapter covers clinical presentation of ABI in a pediatric population. Outcome measures to assess a wide array of difficulties are discussed, as well as interventions targeting acute care management and cognitive/physical deficits during inpatient rehabilitation.
Chapter 5. Mental Health Following Acquired Brain Injury
This chapter covers clinical presentation of, and interventions to treat, neurobehavioural sequlae (depression, anxiety, agitation) post ABI. Descriptions of outcome measures used for these mental health conditions are provided. Interventions include pharmacological and non-pharmacological options for each of the conditions.
Chapter 6. Motor and Sensory Dysfunction Following Acquired Brain Injury
This guidebook chapter addresses common motor and sensory deficits that occur post ABI. Motor deficits include those in the upper and lower extremities as well as spasticity management. Sensory deficits include visual, vestibular, auditory, and pain syndromes.
Chapter 7. Post-Traumatic Seizures Following an Acquired Brain Injury
This chapter covers relevant clinical criteria of post-traumatic seizures following an ABI. Incidence, risk factors, recurrence, and clinical consequences are highlighted. The criteria for diagnosis are discussed in detail. Relevant management and treatment strategies are presented.
Chapter 8. Acute Interventions for Acquired Brain Injury
In this chapter the ERABI Guidebook covers ABI clinical presentation in the acute phase of injury, including intracranial hypertension and coma/disorders of consciouness. The chapter also covers relevant clinical assessments like the Glasgow Coma Scale and outcome measures. Finally, the chapter covers acute interventions and an accompanying case study.
Chapter 9. Heterotopic Ossification and Venous Thromboembolism Post Acquired Brain Injury
This Guidebook chapter covers two topics: Heterotopic Ossification (HO) and Venous Thromboembolism (VTE). Both topics have their respective clinical presentation and incidence discussed, as well as relevant assessments, interventions, and preventative options. Both topics have accompanying case studies.
Chapter 10. Neuroendocrine Function and Disorders after Acquired Brain Injury
In this Guidebook chapter neuroendocrine function and disorders are discussed. An introduction to neuroendocrine disorders is provided with sections covering anatomy, pituitary hormones and bodily responses, epidemiology after ABI, risk factors, pathophysiology, and timing of onset. Signs and symptoms covering anterior and posterior pituitary lobe dysfunction are covered, followed by clinical assessment, screening, and diagnosis. The chapter ends with relevant management strategies and an accompanying case study.
Chapter 11. Community Reintegration Following Acquired Brain Injury
This Guidebook chapter explores reintegration into the community for individuals post-ABI. Several outcome measures and assessments are presented with sections dedicated to life satisfaction, independence and social integration, return to driving, vocational rehabilitation and productivity, and caregiving and caregiver burden. Relevant information and interventions are presented for each. The chapter concludes with a case study.
Chapter 12. Older Age and Traumatic Brain Injury
In this Guidebook chapter clinical presentation, outcome measures and assessments, and outcomes post-TBI for older age adults are explored. Three models of care, triage, acute care, and rehabilitation are presented.
Chapter 13. Fatigue and Sleep Disorders Post Acquired Brain Injury
In this Guidebook chapter classification, epidemiology, risk factors, and more sections are presented for both fatigue and sleep disorders. Clinical assessment, screening, diagnosis, and management of these disorders is explored. The chapter concludes with a case study.