Practical Scale for the Management of Head Injured Patients in Coma or with Possible Multiple Injuries

Background: Aggressive total management of all patients with severe closed head injuries requires much effort and many resources. A clinical scale has been developed for assessing the depth and duration of impaired consciousness.

Method: A protocol for emergency triage of head injuries was presented. Its objectives were to increase the quality of clinical assistance, to avoid unnecessary emergency neurosurgical consultation and to reduce the interhospital transfer of patients.

Result: Emergency neurosurgical consultation was reduced by 80% in Grade 1 and by 85% in Grade II. Moreover, a significant reduction of Hospital readmissions was recorded 1vs 11 (p = 0.01). Conclusion: This head injury chart enables every member of the staff in casualty to view the evolution of any patient at any given moment.


Inaki Arrotegui

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