ORLANDO, Fla. – When someone suffers a traumatic brain injury — whether from a sports accident, car crash or military operation — they're typically taken to the emergency room, where they undergo a CT scan to determine the extent of the injury and what to do next.
However, CT scans involve significant amounts of radiation and often take several hours to produce results.
Not anymore at Orlando Health Hospital.
Orlando Regional Medical Center's emergency room is the first and so far only facility in the world where doctors can run blood tests to determine the extent of brain damage and get results within 15 minutes.
Dr. Linda Papa is an emergency physician at Orlando Health and director of clinical research at Orlando Health.
“You don't even have to leave the patient's bedside. You can just be there with the patient, complete blood tests and make important decisions right there,” Dr. Papa said. “This is amazing. It's going to revolutionize the way we treat traumatic brain injuries.”
For 25 years, she has been interested in researching biomarkers for traumatic brain injury and invented a blood test.
“We had a shoestring budget and no one had done anything like this before,” says Dr. Papa. “From a clinical perspective, I was looking at patients who suffered from mild traumatic brain injury, and it felt like a black box because we weren't doing what we needed to do. So I started looking at different biomarkers in rat models, then humans with severe traumatic brain injury, and then humans with moderate to milder injuries. I remember looking at my data one night — this was about 20 years ago — and I was just stunned and blown away, because the data showed a correlation between these biomarkers and the severity of traumatic brain injury. So it was kind of a 'Eureka' moment. I thought, 'Wow, we've discovered a blood test for brain injury!'”
Dr Papa said he was told by medical professionals that it was a waste of time.
“We decided to give it a try anyway,” Dr. Papa said. “If you think about it, we do blood tests on almost every part of the body, right? We do the heart, lungs, kidneys, liver, but we don't do blood tests on one of our most important organs, the brain. So we knew we needed to bring this technology into the field. We needed to open up this black box and figure out what was going on.”
Dr. Papa said they have identified biomarkers in the bloodstream – essentially different characteristics – that change depending on the severity of the brain injury.
“The utility of such a test is immense. It can be used in ambulances to test patients and triage them for transport to trauma centers,” Dr. Papa said. “It can be used on the sidelines of organized sports to evaluate injured athletes. It can also be used in the military.”
The blood test is currently being used in ORMC's ER, but Abbott Laboratories, the manufacturer of the blood test, is looking to expand it nationwide.
“The test is currently approved for use in adults, but we are developing it for pediatric patients as well because it would be extremely valuable for pediatric patients, particularly those who are non-verbal or unable to express themselves,” Dr. Papa said. “It will tell us what is happening after an injury, so once we get to that stage, it will be extremely useful. We are hopeful that in a few years it will be available for pediatric use as well.”
Dr Papa said the test was not approved to definitively diagnose brain injury, but to detect possible brain injury and provide guidance to doctors.
“This test will tell us the severity of the injury,” Dr. Papa says, “If it's at a very high level, then you may need critical life-saving treatment and may need to go to the operating room and have surgery, or you may need to be admitted to hospital for observation, or you may not be able to go home and have to be hospitalized. Conversely, if we find that the levels are below the red flag level, then we may not need to do a CT scan at all.”
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