Continuing Professional Development: Diagnosis and management of minor head injury in the UK

OverviewHead injury accounts for a large amount of emergency services work in the UK. This article summarizes the findings of studies undertaken for the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme examining the available evidence regarding the diagnostic management of minor head injuries. These studies included a review of current practice in the management of minor head injured patients (GCS 13–15) by way of a survey of UK emergency departments. We also performed a systematic review of the head injury literature to identify the most accurate clinical decision rule for adults (Canadian CT Head Rule) and children (Paediatric Emergency Care and Research Network) and commented on the applicability of these in the UK population. This review helped to identify the most significant clinical findings that increase the likelihood of intracranial and neurosurgical injury, following minor head injury in adults, children and infants. Finally, we have highlighted where these findings may be relevant to UK paramedic practice, in particular in influencing the decision to transfer patients to the emergency department.Learning OutcomesAfter completing this module you will:• Have an understanding of the significant clinical characteristics following head injury• Understand potential pathological problems following head injury• Be able to assess the relevant clinical features of all patients following head injury• Be familiar with key clinical decision rules for patients with head injury• Be able to provide the appropriate pre-hospital management for all head injured patients.

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