Delays in Transfer Times for Patients with Extradural Haematomas in Greater Manchester

Abstract

Decompression surgery for acute extradural haematoma (EDH) should be completed within 240 minutes of the onset of significant symptoms. Previous studies have shown that this time target is rarely met. We investigated all EDH patients requiring surgical intervention who were referred to Salford Royal Foundation Trust in a six-month period to establish the causes of delay in definitive treatment. The study showed a median time of 384 minutes (range 198–704) from admission to the recipient emergency department to the commencement of surgical decompression. Analysis of the timeline of treatment showed that the attainment of initial CT scan and preparation for transfer were the primary factors delaying definitive treatment. We recommend altering the approach to certain key processes, namely attainment of CT, the referral process and the preparation for transfer, in order to achieve the 240-minute target.