Computerised tomography and acute traumatic head injury: time for change?
The aim was to reconsider the "Guidelines for initial management of head injury in adults"--particularly with respect to the indications for computerised tomographic (CT) scanning--suggested by "a group of neurosurgeons" over a decade ago and still followed in some accident and emergency (A&E) departments. These recommendations are placed in the context of more recent research and the increased number of A&E departments with on-site rapid access to a CT scanner but without a resident neurosurgical facility. A case can be made for an updated policy with more liberal indications for CT scanning of acutely head injured adults in peripheral A&E departments. However, calculating the cost-efficiency of more frequent use of what is now a common but relatively expensive resource would remain a challenge.
Cranshaw
J
J
Department of Accident and Emergency Medicine, Bristol Royal Infirmary, United Kingdom.
Hughes
G
G
Clancy
M
M
D000208:Acute Disease; D000328:Adult; D000465:Algorithms; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D006801:Humans; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data