{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:56:08Z","timestamp":1793606168257,"version":"4.5.0"},"reference-count":0,"publisher":"Scientific Scholar","issue":"01","license":[{"start":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T00:00:00Z","timestamp":1583193600000},"content-version":"vor","delay-in-days":62,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosci Rural Pract"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\nBackground\u2003Traumatic brain injury (TBI) is a global public health problem. In Colombia, it is estimated that 70% of deaths from violence and 90% of deaths from road traffic accidents are TBI related. In the year 2014, the Ministry of Health of Colombia funded the development of a clinical practice guideline (CPG) for the diagnosis and treatment of adult patients with severe TBI. A critical barrier to the widespread implementation was identified\u2014that is, the lack of a specific protocol that spans various levels of resources and complexity across the four treatment phases. The objective of this article is to present the process and recommendations for the management of patients with TBI in various resource environments, across the treatment phases of prehospital care, emergency department (ED), surgery, and intensive care unit.<\/jats:p><jats:p>\nMethods\u2003Using the Delphi methodology, a consensus of 20 experts in emergency medicine, neurosurgery, prehospital care, and intensive care nationwide developed recommendations based on 13 questions for the management of patients with TBI in Colombia.<\/jats:p><jats:p>\nDiscussion\u2003It is estimated that 80% of the global population live in developing economies where access to resources required for optimum treatment is limited. There is limitation for applications of CPGs recommendations in areas where there is low availability or absence of resources for integral care. Development of mixed methods consensus, including evidence review and expertise points of good clinical practices can fill gaps in application of CPGs. BOOTStraP (Beyond One Option for Treatment of Traumatic Brain Injury: A Stratified Protocol) is intended to be a practical handbook for care providers to use to treat TBI patients with whatever resources are available.<\/jats:p><jats:p>\nResults\u2003Stratification of recommendations for interventions according to the availability of the resources on different stages of integral care is a proposed method for filling gaps in actual evidence, to organize a better strategy for interventions in different real-life scenarios. We develop 10 algorithms of management for building TBI protocols based on expert consensus to articulate treatment options in prehospital care, EDs, neurological surgery, and intensive care, independent of the level of availability of resources for care.<\/jats:p>","DOI":"10.1055\/s-0040-1701370","type":"journal-article","created":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T00:00:08Z","timestamp":1583280008000},"page":"007-022","source":"Crossref","is-referenced-by-count":78,"title":["Recommendations of the Colombian Consensus Committee for the Management of Traumatic Brain Injury in Prehospital, Emergency Department, Surgery, and Intensive Care (Beyond One Option for Treatment of Traumatic Brain Injury: A Stratified Protocol [BOOTStraP])"],"prefix":"10.25259","volume":"11","author":[{"given":"Andres M.","family":"Rubiano","sequence":"additional","affiliation":[{"name":"NIHR Global Health Research Group in Neurotrauma, University of Cambridge, UK\/Neurosciences Institute, Universidad El Bosque, Bogot\u00e1, Colombia\/Meditech Foundation, Cali, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Vera","sequence":"additional","affiliation":[{"name":"MEDITECH Foundation, Universidad El Bosque, Bogota, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge H.","family":"Montenegro","sequence":"additional","affiliation":[{"name":"Emergency Service, Local Hospital of Puerto As\u00eds, Putumayo, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Carney","sequence":"additional","affiliation":[{"name":"School of Medicine, Oregon Health & Science University, Portland, Oregon, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Clavijo","sequence":"additional","affiliation":[{"name":"INUB MEDITECH, Universidad El Bosque, Clinical Research, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose N.","family":"Carre\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Fundaci\u00f3n Santa F\u00e9 University Hospital, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Neurosurgery Service, Hospital Occidente de Kennedy, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Mejia","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Valle de Lili Foundation, Cali, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan D.","family":"Ciro","sequence":"additional","affiliation":[{"name":"Intensive Care Service, Las Am\u00e9ricas Clinic, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ninel D.","family":"Barrios","sequence":"additional","affiliation":[{"name":"Intensive Care Service, Cl\u00ednica General del Norte, Barranquilla, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro R.","family":"Soto","sequence":"additional","affiliation":[{"name":"Neurosurgery Service, San Antonio Departamental Hospital, Pitalito-Huila, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola A.","family":"Tejada","sequence":"additional","affiliation":[{"name":"Institute of Neurosciences, Universidad El Bosque, Clinical Research, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C.","family":"Zerpa","sequence":"additional","affiliation":[{"name":"Intensive Care Service, Cl\u00ednica Del Norte, C\u00facuta, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Gomez","sequence":"additional","affiliation":[{"name":"Prehospital Care Program, Adventist University, Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norberto","family":"Navarrete","sequence":"additional","affiliation":[{"name":"Burns Unit, Sim\u00f3n Bol\u00edvar Hospital, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Echeverry","sequence":"additional","affiliation":[{"name":"Clinical Research, MEDITECH Foundation, Cali, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Uma\u00f1a","sequence":"additional","affiliation":[{"name":"Intensive Care Service, Clinica Amiga, Cali, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia M.","family":"Restrepo","sequence":"additional","affiliation":[{"name":"Neurosurgery Service, Hospital Militar Central, Bogota, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose L.","family":"Castillo","sequence":"additional","affiliation":[{"name":"Intensive Care Service, Vallesalud Clinic, Cali, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar A.","family":"Sanabria","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria P.","family":"Bravo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad Surcolombiana, Neiva, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia M.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Neurosurgery Service, Urab\u00e1 Clinic, Apartad\u00f3-Antioquia, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Godoy","sequence":"additional","affiliation":[{"name":"Intensive Care Service, Sanatorium Pasteur, Catamarca, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"German D.","family":"Orjuela","sequence":"additional","affiliation":[{"name":"Prehospital Care Program, Secretary of Health, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto A.","family":"Arias","sequence":"additional","affiliation":[{"name":"Intensive Care Service, Cl\u00ednica del Norte, C\u00facuta, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul A.","family":"Echeverri","sequence":"additional","affiliation":[{"name":"Neurosurgery Service, Vallesalud Clinic, Cali, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Paranos","sequence":"additional","affiliation":[{"name":"Neurosurgery and Intensive Care Service, Santa Casa da Miseric\u00f3rdia Hospital in S\u00e3o Jo\u00e3o del-Rei, S\u00e3o Jo\u00e3o del-Rei, Minas Gerais, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2020,3,3]]},"container-title":["Journal of Neurosciences in Rural 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