Prehospital treatment of head injuries ‐ can we do better?

Abstract

AbstractAimsTo examine prehospital factors associated with head injuries.MethodPrehospital and outcome data were collected on a group of 123 patients with head injuries admitted to Waikato Hospital over 41 months.ResultsOver 80% of the head injuries were due to road trauma. Over 60% occurred >30km from the first admission hospital, 35% were >60km away and 43% took more than 90 minutes to arrive in hospital. Helicopter transport was used for 34% of patients. Hypoxia was present in 50% of the patients at the accident scene and 54% of the unintubated patients were breathing poorly on admission to hospital (64% unintubated). The average Glasgow Coma Scale score was 5.4. Glasgow Outcome Scores at six months were: dead (24), vegetative (0), severely disabled (25), moderately disabled (19), normal or mildly disabled (40), and not available (15). The presence of hypoxia and the worst Abbreviated Injury Scale scores occurred more commonly in those who died.ConclusionsMany New Zealanders suffer head injuries a long distance from hospital. The use of helicopter transport shortens admission times. Poor breathing patterns and hypoxia are still major problems. Facilitating early intubation by widening the skills of ambulance officers or utilising doctors in first response teams must be considered.