Management of traumatic head injuries in a rural Irish hospital: implications of the NICE guidelines.
BACKGROUND
The NICE guidelines were published in 2003 in an effort to standardise the management of traumatic head injuries, and advise a CT brain in certain situations.


OBJECTIVE
To evaluate the influence of the NICE guidelines on the management of head injuries in a county hospital.


METHODS
Complete clinical data were obtained for all patients with traumatic head injuries attending the ED of a county hospital from 2001 to 2005. Symptoms, examination details and outcome data were made available. The influence of the NICE guidelines on their management was then evaluated.


RESULTS
Application of the NICE guidelines to these patients would have resulted in a 56% increase in the rate of CT brains being performed. No patient who did not have a CT brain had an adverse outcome.


CONCLUSIONS
It is possible with limited resources and normal neurological observations that patients over the age of 65 can be managed safely.
Department of Surgery and Emergency Medicine, Roscommon County Hospital, Roscommon, Ireland. johncokelly@gmail.com
J C
JC
Kelly
A
A
O'Callaghan
L
L
Mc Mullin
O
O
Clinton
J
J
Binchy
D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000191:economics / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006780:Hospitals, Rural / Q000191:economics; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D017410:Practice Guidelines as Topic; D040841:Resource Allocation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000706:statistics & numerical data; D055815:Young Adult