Ohio State Issues First-Responder Brain Injury Guidelines

Ohio State experts publish 28 consensus recommendations for diagnosing and managing traumatic brain injuries among first responders.

Updated on Nov. 4, 2026 in Stroke

Ohio State Issues First-Responder Brain Injury Guidelines

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Do you think local police and fire agencies do enough to protect workers from brain injuries?

More than 50 experts at The Ohio State University published 28 consensus-based recommendations on October 16 in The Journal of Head Trauma Rehabilitation for recognizing, diagnosing, and managing traumatic brain injuries among law enforcement, corrections personnel, firefighters, and emergency medical technicians.

Why it matters

Traumatic brain injuries among first responders often go undiagnosed and are viewed primarily as a sports problem, while these workers face risks from violent encounters, falls, and vehicle crashes on the job. The guidelines are the first consensus-based approach covering this group.

A statewide Ohio survey found 64.1% of law enforcement and corrections officers had at least one lifetime traumatic brain injury, and nearly three-quarters of duty-related injuries were never diagnosed or treated. The causes and recovery timelines for these injuries remain under study.

The players

Jaclyn Caccese

Caccese is an associate professor at The Ohio State University and lead author of the recommendations, whose work focuses on concussion and brain injury in athletes and service members.

The Ohio State University

Ohio State is a public research university in Columbus, Ohio, whose experts developed the consensus recommendations and are leading the federally funded officer study.

National Institute for Occupational Safety and Health

NIOSH is the federal agency within the Centers for Disease Control and Prevention that conducts research on workplace injury and illness and is funding the $1.9 million study.

The details

The guidelines contain 28 recommendations across five priorities: recognizing injuries quickly, supporting safe recovery, determining when workers can return to duty, reducing stigma, and providing care centered on first responders. They call for agencies to take greater responsibility for identifying and managing these injuries through non-punitive reporting, medical referrals, clinician-guided treatment, and a gradual, job-specific return to duty.

October 16: Recommendations published in The Journal of Head Trauma Rehabilitation.
72 hours after injury: First planned symptom evaluation in the federally funded study.
Six months later: Final planned symptom evaluation in the federally funded study.

Big Picture

The Ohio State study extends the federal occupational injury research that the National Institute for Occupational Safety and Health funds, applying it to brain injuries among first responders. It follows a pattern of treating workplace head trauma as a professional health issue rather than only a sports concern.

Officers, firefighters, and EMTs who sustain head injuries on the job may now have clearer guidance on reporting and treatment through their agencies. Agencies adopting the recommendations would set up non-punitive reporting and job-specific return-to-duty steps.

The takeaway

Recognizing a head injury early and reporting it without fear of punishment can help first responders get appropriate care. Workers and agencies alike can ask whether return-to-duty decisions follow a clinician-guided, gradual process.

What happens next

Researchers plan to evaluate officers' symptoms at 72 hours after injury, after symptoms resolve, when cleared for unrestricted duty, and six months later, and the next step is working with first responder agencies to put the recommendations into practice.