The study was sufficiently large to demonstrate higher levels of patient satisfaction and clinical documentation quality with ENP-led than SHO-led care. A larger study involving 769 patients in each arm would be required to detect a 2% difference in missed injury rates. The methods and tools used in this trial could be used in Accident and Emergency departments to measure the quality of ENP-led care.
Psychological distress was associated with having traumatic or no memories of an index event. Amnesia for the event did not protect against PTSD; however, it does appear to protect against the severity and presence of specific intrusive symptoms.
Objective: To test the following hypothesis in the assessment of head injury patients: only patients with 5 min or more of post-traumatic amnesia (PTA) are at risk of acute olfactory dysfunction (OD). Methods: This was a retrospective comparative study of olfactory status in head injury patients seen at a head injury clinic at Glasgow Royal Infirmary from 1985 to 2003. Of 828 clinic attenders, 101 had acute OD. These subjects were compared with a randomly selected control group of 102 patients with head injury but normal olfactory function. The main outcome measure was a significant likelihood of patients with PTA lasting for 5 or more minutes having acute OD compared with those with PTA of less than 5 min. Results: The likelihood of patients with a PTA of 5 min or more having acute OD compared to those with PTA of less than 5 min is clinically significant with an odds ratio of 9.6 (p,0.01). Conclusion: Examination of patients with 5 min or more of PTA should include a simple test of sense of smell. Patients with impaired smell sensation should be aware of their condition prior to discharge from hospital. In addition, the need for a CT brain scan and appropriate follow up should be considered.
Aim: To survey the information provided to head-injured patients on discharge from emergency departments (EDs) in Scotland. Methods: EDs throughout Scotland were asked to supply a copy of their head injury advice pamphlet for analysis. Each pamphlet was assessed against a template and an Excel spreadsheet was created. Results: All 30 (100%) Scottish EDs responded. The frequency with which specific features appeared varied widely, with most pamphlets concentrating on emergency features, with less emphasis on postconcussion symptoms. Conclusions: Head injury discharge advice should be standardised throughout EDs, with more emphasis given to postconcussion features.
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