Guidelines for the management of head injuries in remote and rural Alaska.
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.
Sacco
Frank
F
Department of Surgery, Alaska Native Medical Center, 4315 Diplomacy Drive, Anchorage, AK 99508, USA. fsacco@anmc. org
Zafren
Ken
K
Brown
Ken
K
Cohen
Tim
T
Coopes
B J
BJ
Godersky
John
J
Hudson
Don
D
Hyams
Steve
S
Ingraham
David
D
Levy
Mike
M
Ma
William
W
Martinez
Patricia
P
Montano
William
W
Mithun
John
J
O'Malley
James
J
O'Neill
Karen
K
Powers
David
D
Smith
Linda
L
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