Diagnosis and management of minor head injury in the UK

Abstract

Head injury accounts for a large amount of emergency services work in the UK. We performed 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. Nearly all departments (∼95%) reported unrestricted access to computer tomography (CT) scans. Admission rates for minor head injured patients were 18% for adults and 9% for children. From our systematic review, we identified the most accurate clinical decision rule for adults (Canadian CT Head Rule) and children (Pediatric Emergency Care and Research Network) and commented on the applicability of these in the UK population. We also identified 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. 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. It will be published in a number of articles and a full report for the HTA programme.