Returning the patient to the community
The last link of the trauma system care chain is to return the injured individual to his or her place in the community. This involves the integration of initial ‘high tech’ medicine and rehabilitation services and attention to the psychological needs of the patient. Training is required for staff caring for patients as well as those supporting relatives. Long lasting psychological and social suffering of relatives may result from the way they are approached
by emergency care givers .
Patients who have sustained traumatic brain injury (TBI) will require additional specialised attention on the part of neuropsychologists and psychologists. Research shows that even relatively ‘mild TBI’ is followed by prolonged disability in a high percentage of cases. In hospital trauma care a neuropsychologist should take part in the acute rehabilitation phase. Psychologists should be involved in the ‘discharge planning’ of all patients with TBI and be consulted whenever there is concern about the re-integration of a patient into the community. Post traumatic stress disorder is recognised as a major obstacle to full recovery after injury. It is probable that early assessment and early referral for rehabilitation will improve long term outcome and speed up the recovery process.
Other injuries e.g. of the spine and the upper and lower limbs can also be debilitating and rehabilitation of these patients should receive the necessary attention.