EXperienceS and aTtitudes towards Agitated behaviours in Traumatic brain injury in the Intensive Care unit patients (EXSTATIC): a protocol for an interprofessional mixed-method study

IntroductionAgitation and violent behaviours are common conditions developed by patients with acute traumatic brain injury (TBI) in intensive care units (ICUs). Healthcare professionals caring for these patients have various tools to manage these behaviours, but lack of a formal protocol to assess and manage them makes caring for these patients a challenge. Moreover, safety may often be compromised for both ICU professionals and patients encountering such situations. The EXperienceS and aTtitudes towards Agitated behaviours in Traumatic brain injury in the Intensive Care unit patients (EXSTATIC) study aims to explore the experiences and attitudes of ICU nurses and other ICU healthcare professionals on the management of agitated behaviours in patients with acute TBI.Methods and analysisEXSTATIC is a multicenter mixed methods convergent study exploring experiences and attitudes of ICU healthcare professionals caring of agitated patients with TBI. The study includes three qualitative methods (observation, semistructured interviews and focus groups) and one quantitative method (retrospective cohort). The integration of the different methods will be done using sequential steps of the research and by the integration of results for each step. Qualitative data will be evaluated following a thematic analysis derived from a grounded theory approach. Quantitative data will be analysed using descriptive statistics. Qualitative and quantitative results will be combined in a convergent interactive interpretative design. Gender and race perspective will be integrated in collection, analysis and interpretation of data.Ethics and disseminationThis study has been approved by the Centre intégré universitaire de santé et de services sociaux du nord de l’île de Montréal (CIUSSS-NÎM) Research Ethics Board. The findings will be disseminated locally with ICU staff and health managers, international peer-reviewed journals, a PhD dissertation, and national and international conferences. The knowledge derived from this study is key in the development of clinical protocols to manage agitation and related behaviours in patients with TBI and designing further interventional studies targeting this specific problematic.Trial registration numberNCT04741399.

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Secondary stroke in patients with polytrauma and traumatic brain injury treated in an Intensive Care Unit, Karlovac General Hospital, Croatia

Injury ◽

10.1016/j.injury.2015.10.057 ◽

2015 ◽

Vol 46 ◽

pp. S31-S35 ◽

Cited By ~ 1

Author(s):

M. Belavić ◽

E. Jančić ◽

P. Mišković ◽

A. Brozović-Krijan ◽

B. Bakota ◽

...

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

General Hospital

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Behavioral Pain Indicators in Patients with Traumatic Brain Injury Admitted to an Intensive Care Unit

Journal of Caring Sciences ◽

10.15171/jcs.2018.030 ◽

2018 ◽

Vol 7 (4) ◽

pp. 197-203 ◽

Cited By ~ 1

Author(s):

Roghieh Nazari ◽

Saeed Pahlevan Sharif ◽

Kelly A Allen ◽

Hamid Sharif Nia ◽

Bit-Lian Yee ◽

...

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Injury Severity ◽

Repeated Measure ◽

Neck Stiffness ◽

Significant Difference ◽

Eye Opening ◽

Different Levels

Introduction: A consistent approach to pain assessment for patients admitted to intensive care unit (ICU) is a major difficulty for health practitioners due to some patients’ inability, to express their pain verbally. This study aimed to assess pain behaviors (PBs) in traumatic brain injury (TBI) patients at different levels of consciousness. Methods: This study used a repeated-measure, within-subject design with 35 patients admitted to an ICU. The data were collected through observations of nociceptive and non-nociceptive procedures, which were recorded through a 47-item behavior-rating checklist. The analyses were performed by SPSS ver.13 software. Results: The most frequently observed PBs during nociceptive procedures were facial expression levator contractions (65.7%), sudden eye openings (34.3%), frowning (31.4%), lip changes (31.4%), clear movement of extremities (57.1%), neck stiffness (42.9%), sighing (31.4%), and moaning (31.4%). The number of PBs exhibited by participants during nociceptive procedures was significantly higher than those observed before and 15 minutes after the procedures. Also, the number of exhibited PBs in patients during nociceptive procedures was significantly greater than that of exhibited PBs during the non-nociceptive procedure. The results showed a significant difference between different levels of consciousness and also between the numbers of exhibited PBs in participants with different levels of traumatic brain injury severity. Conclusion: The present study showed that most of the behaviors that have been observed during painful stimulation in patients with traumatic brain injury included facial expressions, sudden eye opening, frowning, lip changes, clear movements of extremities, neck stiffness, and sighing or moaning.

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The relationship between vasoactive-inotropic score and mortality in the adult patients with traumatic brain injury managed in the intensive care unit

Turkish Neurosurgery ◽

10.5137/1019-5149.jtn.25177-18.1 ◽

2018 ◽

Author(s):

Iskender Kara ◽

Mehmet Sargin ◽

Yesim Serife Bayraktar ◽

Mert Sahinoglu ◽

Gurban Ildarov ◽

...

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Adult Patients ◽

Inotropic Score ◽

Vasoactive Inotropic Score ◽

The Relationship

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INCIDENCE OF ACUTE CORONARY SYNDROME AFTER TRAUMATIC BRAIN INJURY IN INTENSIVE CARE UNIT (ASSOCIATED FACTORS AND MORTALITY): A RETROSPECTIVE STUDY

The Egyptian Journal of Forensic Sciences and Applied Toxicology ◽

10.21608/ejfsat.2019.12306.1074 ◽

2020 ◽

Vol 20 (1) ◽

pp. 1-14

Author(s):

Adel Diab ◽

Mahmoud Hussein ◽

Amal Ahmed

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Acute Coronary Syndrome ◽

Intensive Care ◽

Retrospective Study ◽

Brain Injury ◽

Associated Factors ◽

Coronary Syndrome

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A population-based study on epidemiology of intensive care unit treated traumatic brain injury in Iceland

Acta Anaesthesiologica Scandinavica ◽

10.1111/aas.12869 ◽

2017 ◽

Vol 61 (4) ◽

pp. 408-417 ◽

Cited By ~ 4

Author(s):

G. M. Jonsdottir ◽

S. H. Lund ◽

B. Snorradottir ◽

S. Karason ◽

I. H. Olafsson ◽

...

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Population Based ◽

Population Based Study

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Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

Clinical Nursing Research ◽

10.1177/10547738211050489 ◽

2021 ◽

pp. 105477382110504

Author(s):

Jeong Eun Yoon ◽

Ok-Hee Cho

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Medical Records ◽

Injury Severity ◽

University Hospital ◽

Factors Associated ◽

Braden Scale

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

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