title: Guidelines for the management of head injuries in remote and rural Alaska.
abstract: Numerous recommendations on the initial evaluation and treatment of the head injured patient have been proposed over the last several years. Most assume there is readily available access to computed tomography and neurosurgical specialists. Many clinicians in Alaska must evaluate and begin treatment of head injured patients in circumstances quite different from this. Vast distances, severe weather and limited medical evacuation capability are factors that come into play while caring for these patients. The current medicolegal climate also contributes to clinician anxiety over missing rare but potentially serious injuries. These guidelines developed by Alaska clinicians from multiple specialties are meant to assist clinicians dealing with this very common problem and represent a reasonable approach to these patients in remote and rural Alaska.
authors.affiliation: Department of Surgery, Alaska Native Medical Center, 4315 Diplomacy Drive, Anchorage, AK 99508, USA. fsacco@anmc. org
authors.forename: Frank
authors.initials: F
authors.lastname: Sacco
authors.forename: Ken
authors.initials: K
authors.lastname: Zafren
authors.forename: Ken
authors.initials: K
authors.lastname: Brown
authors.forename: Tim
authors.initials: T
authors.lastname: Cohen
authors.forename: B J
authors.initials: BJ
authors.lastname: Coopes
authors.forename: John
authors.initials: J
authors.lastname: Godersky
authors.forename: Don
authors.initials: D
authors.lastname: Hudson
authors.forename: Steve
authors.initials: S
authors.lastname: Hyams
authors.forename: David
authors.initials: D
authors.lastname: Ingraham
authors.forename: Mike
authors.initials: M
authors.lastname: Levy
authors.forename: William
authors.initials: W
authors.lastname: Ma
authors.forename: Patricia
authors.initials: P
authors.lastname: Martinez
authors.forename: William
authors.initials: W
authors.lastname: Montano
authors.forename: John
authors.initials: J
authors.lastname: Mithun
authors.forename: James
authors.initials: J
authors.lastname: O'Malley
authors.forename: Karen
authors.initials: K
authors.lastname: O'Neill
authors.forename: David
authors.initials: D
authors.lastname: Powers
authors.forename: Linda
authors.initials: L
authors.lastname: Smith
mesh_terms: D000413:Alaska; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000628:therapy*; D015600:Glasgow Coma Scale; D006801:Humans; D008507:Medically Underserved Area; D012307:Risk Factors; D019035:Rural Health Services / Q000592:standards*; D014057:Tomography, X-Ray Computed; D014474:Unconsciousness