Head Injury: Triage, Assessment, Investigation and Early Management of Head Injury in Infants, Children and Adults

Excerpt

The guideline covers best practice advice on the care of adults, children (aged 1–15 years) and infants (under one year) who present with a suspected or confirmed traumatic head injury with or without other major trauma. In certain circumstances, the age group ‘infants and young children’ (that is, those aged under 5 years) is used. Cut-off points of 10 years and 12 years are also used. The guideline will offer advice on the management of patients with a suspected or confirmed head injury who may be unaware that they have sustained a head injury because of intoxication or other causes. The primary patient outcome of concern throughout the guideline is ‘clinically important brain or cervical spine injury’. For the purposes of this guideline, clinically important brain or cervical spine injury is defined as any acute condition that has been identified by imaging or by assessment of risk factors.

This update covers the following: the benefits of transporting patients with head injuries to a neurosciences unit compared to an emergency department; the benefits of secondary transfer of patients; the best imaging tool for identifying patients with head and cervical spine injuries; the best clinical prediction rule for selecting patients with head and cervical spine injuries for the imaging tool selected; evidence on harm associated with radiation to the head and/or spine; identification of patients who should be referred to rehabilitation services following the initial management of a head injury.

Copyright © 2007, National Collaborating Centre for Acute Care.