TIME is critical in head injuries and patients should be transported directly to a hospital with resuscitation facilities where staff can investigate and commence treatment, says NICE.
In updated guidance aimed primarily at hospital doctors, nurses and ambulance crews, NICE stresses the importance of early detection and prompt treatment for both children and adults who have suffered head trauma.
Each year an estimated 1.5 million people go to their local A&E department with a recently sustained head injury. Two hundred thousand are admitted to hospital and of these around one in five will have a serious head injury or brain damage.
Among key changes in the guidance NICE advises that ambulance crews should take patients with a head injury straight to a hospital with resuscitation facilities where doctors and nurses can investigate and treat their injuries.
Children and adults who have suffered a head injury but also begin to show particular signs that the injury may be serious or potentially life-threatening (such as seizures, suspected skull fracture, repeated vomiting or loss of consciousness) should be given a CT brain scan within one hour. Others should be scanned within four to eight hours of their injury, depending on its severity.
A hospital doctor or specialist who is trained in safeguarding (e.g. potential abuse) should be involved in checking any patient with a head injury presenting to A&E, especially if it's a possible non-accidental injury or a vulnerable person has been injured. Doctors and nurses should give verbal and printed advice to patients with any type of head injury who are discharged from an emergency department or observation ward – and their families and carers.
Fiona Lecky, Consultant in Emergency Medicine at the University of Sheffield, University of Manchester and Salford Royal NHS Foundation Trust and Chair of the GDG, said: "Head injuries are the most common cause of death and disability in people up to the age of 40. How quickly a person receives treatment for their head injury can make all the difference to their life. New technology and techniques means the NHS is able to assess people more quickly and care can be managed in more specialist centres. This updated guideline reflects the very best practice available, which I have no doubt will result in fewer people dying from their head injury."
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