Audit of head injury management in Accident and Emergency at two hospitals: implications for NICE CT guidelines

Miller, Lucy; Kent, Ruth; Tennant, Alan

doi:10.1186/1472-6963-4-7

Cited by 15 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is noteworthy that CT head scans performed for head injuries from the A&E went up in this period when the change in practice of handling calls for out-of-hours imaging was implemented and almost half of the scans requested were for head injuries. Although the trend of increase in A&E head injury CT scans with the advent of NICE guidelines is consistent with other published studies [ 1 - 5 ], the results fall short of statistical significance. This was probably because the lack of study power, which was one of the limitations of our study.…”

Section: Discussionsupporting

confidence: 78%

Audit of the change in the on-call practices in neuroradiology and factors affecting it

2006

View full text Add to dashboard Cite

BackgroundOn call practices had recently changed at the Newcastle General Hospital to accommodate increasing CT scan requests and reduce the workloads of the radiologists. In the new system, the person responsible for dealing with the out of hours requests for imaging changed from the neuroradiologist to the neuroradiographer. This audit was conducted to assess any change in the departmental workload as a result of this change.MethodsThe audit was carried out over a period of six months and data was collected from the on-call booklets which the neuroradiographers maintained and the log books maintained in the department of neuroradiology. Details of the imaging requested; the source of the request, the reason for the request and the results of the scans were recorded and analysed using Microsoft Excel™.ResultsThe number of CT scans requested from the A&E went up by 73.4% after the change in practice and majority of these increases were due to increased requests for scans on head injuries which increased by 122%. Although this was not statistically significant due to lack of study power, it is clinically relevant.ConclusionThe increase in the number of CT scans for head injuries reflects a general change in practice in management of head injuries in the UK. Changing the gatekeeper from radiologist to radiographer was associated with an increase in CT rate, particularly for head injuries. Other factors such as clinician seniority and a greater awareness of the NICE guidelines may have also contributed.

show abstract

Section: Discussionsupporting

confidence: 78%

Audit of the change in the on-call practices in neuroradiology and factors affecting it

2006

View full text Add to dashboard Cite

show abstract

“…28,31,34,40,41 This is also true of other trauma caused by various mechanisms such as falls and motor vehicle crashes, where most of the patients are males. 28,34 Although our study population depicted that the predominant race is mainly African American, this is not typical of findings in other similar studies 28,31,40,41 ; this variation is likely due to the patient demographics of the surrounding community served by CHW. Our findings show that the level of agreement between the P and ED GCS scores was good.…”

Section: Discussionmentioning

confidence: 95%

Does a Prehospital Glasgow Coma Scale Score Predict Pediatric Outcomes?

Nesiama¹,

Pirallo²,

Lerner³

et al. 2012

Pediatric Emergency Care

View full text Add to dashboard Cite

show abstract

“…It was discovered that undiagnosed intracranial hematomas often have tragic consequences in apparently mild TBI patients 35 and that CT scans reveal intracranial lesions in this population more commonly than expected. 36 Although there were pleas for more liberal use of CT scans in mild TBI, 37,38 several authorities suggested that this would be too costly, [39][40][41][42] and the concern persists to this day. 43 Studies have confirmed that a liberal policy of CT scans for mild TBI can be delivered cost-effectively.…”

Section: Neurosurgical Clinical Prediction and Decision Rulesmentioning

confidence: 99%

Clinical Prediction and Decision Rules in Neurosurgery

Stein

Attiah

2015

Neurosurgery

View full text Add to dashboard Cite

Clinical prediction and decision rules use evidence-based medicine to assist clinicians in diagnosing and treating illness. Although widespread in modern medical practice, there are relatively few clinical rules for neurosurgical conditions. This article reviews the background of how clinical prediction and decision rules are derived, validated, evaluated, and used in practice. It also summarizes a list of clinical rules published for neurosurgical illnesses and analyzes each rule for how it was derived and whether it was validated and/or evaluated compared with similar rules. It reports on whether the implementation of each rule was studied and grades the overall quality of each report.

show abstract

Audit of head injury management in Accident and Emergency at two hospitals: implications for NICE CT guidelines

Cited by 15 publications

References 11 publications

Audit of the change in the on-call practices in neuroradiology and factors affecting it

Audit of the change in the on-call practices in neuroradiology and factors affecting it

Does a Prehospital Glasgow Coma Scale Score Predict Pediatric Outcomes?

Clinical Prediction and Decision Rules in Neurosurgery

Contact Info

Product

Resources

About