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Management of head injuries requiring admission in acute surgical setting

Ms Monika Rezacova, Mr Alex Rothnie, UK

Almost everyone came across head injury patients during their surgical career. The management differs from hospital to hospital but there are certain amount of patients who stay for long period of time following head injuries for reasons that are not related to the injury itself.
Establish how many cases follow NICE guidelines for head injuries in adult patients. As a secondary aim to look into reasons for prolonged stay in hospital.
100 patients has been picked up retrospectively from December 2016. The criteria for inclusion have been: adult patient, head injury requiring admission. Patients were excluded if the management was done by emergency doctors only and did not require admission. Children patients have been also excluded.
In 30% of cases the NICE guidelines have not been followed. In 35% of admissions there was prolonged stay (more than required for head injury monitoring) with significant increase in elderly patients.
The NICE guidelines give excellent pathway to look after head injuries. If admission is required, patients should be placed in CDU or similar unit with minimal exposure to other admitted patients to try and prevent infection. There should be early physio assessment and aim for quick discharge. In group of elderly patient or patients with complex medical history, admissions to medical unit might be beneficial.

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