Initial assessment and outcome of head injured patients transferred to a regional neurosurgical service: what do we miss?

OBJECTIVE: To assess the level of missed extracranial injuries in patients transferred to a regional neurosurgical service for ongoing head injury management. METHODS: A three year prospective study conducted under the auspices of the Scottish Trauma Audit Group. All patients were followed during th...

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Published in:Emergency medicine journal : EMJ 1997-01, Vol.14 (1), p.10-12
Main Authors: Grant, P T, Shrouder, S
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Craniocerebral Trauma - diagnosis
Diagnostic Errors
Emergency Service, Hospital
Female
Humans
Male
Medical Audit
Middle Aged
Multiple Trauma - diagnosis
Neurosurgery
Outcome Assessment (Health Care)
Patient Transfer
Prospective Studies
Regional Medical Programs
Scotland
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container_title Emergency medicine journal : EMJ
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creator Grant, P T
Shrouder, S
description OBJECTIVE: To assess the level of missed extracranial injuries in patients transferred to a regional neurosurgical service for ongoing head injury management. METHODS: A three year prospective study conducted under the auspices of the Scottish Trauma Audit Group. All patients were followed during their hospital stay by independent audit staff, their injuries being recorded and scored using established criteria. RESULTS: 115 head trauma patients were transferred during the study period. 15 patients died (13% mortality). Eight of a total of 87 separate, scorable extracranial injuries were missed (error rate 9%), none of which was serious. There were no missed injuries in patients who died. 77% of patients were managed by an accident and emergency doctor of at least registrar grade. CONCLUSIONS: In contrast to other published series, this study has shown a low rate of missed extracranial injuries in a group of patients whose initial assessment is notoriously difficult. Early involvement by an experienced accident and emergency doctor may play an important part in the overall management of such patients.
doi_str_mv 10.1136/emj.14.1.10
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subjects Adolescent
Adult
Aged
Craniocerebral Trauma - diagnosis
Diagnostic Errors
Emergency Service, Hospital
Female
Humans
Male
Medical Audit
Middle Aged
Multiple Trauma - diagnosis
Neurosurgery
Outcome Assessment (Health Care)
Patient Transfer
Prospective Studies
Regional Medical Programs
Scotland
title Initial assessment and outcome of head injured patients transferred to a regional neurosurgical service: what do we miss?
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