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Over 50 experts—clinicians, researchers, policymakers, first responders and representatives from agencies that employ and advocate for them—have reached consensus on the first recommendations for the recognition, diagnosis and management of traumatic brain injury in first responders.
Publishing today (Oct. 16, 2026) in The Journal of Head Trauma Rehabilitation, the 52 authors agreed to 28 recommendations designed to help first responders, health care professionals and agencies work toward five primary goals: timely recognition of traumatic brain injury (TBI), safe recovery, operational readiness, reduced stigma and first responder–centered care.

Researchers and clinicians at The Ohio State University assembled the team that developed the guidelines, which apply to law enforcement officers, corrections personnel, firefighters and emergency medical technicians (EMTs)—a group of professionals at high risk for violent interactions, falls and car crashes working in a demanding culture that makes it tough to seek help.

While addressing injury prevention, treatment and return to duty, the recommendations also recognize that better outcomes will require education, supportive reporting practices and organizational cultures that enable first responders to identify injuries and access appropriate care. The authors wrote in the paper that management of traumatic brain injuries in first responders "must shift from an individual burden to an organizational responsibility."

"The first step is recognizing that TBI is a problem in first responders. I think everybody thinks of it as a sports problem, but there are a lot of other populations that TBI impacts, and, clearly, first responders are one of them," said lead author Jaclyn Caccese, associate professor in the School of Health and Rehabilitation Sciences at Ohio State.

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