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drfiazfazili 3 Years ago. |
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Acute head injury admissions account for
320,900 bed days in hospitals in
England (plus a further moreAcute head injury admissions account for
320,900 bed days in hospitals in
England (plus a further 19,000 in Wales
by population extrapolation)
representing 0.64% of all NHS bed
days. 2,3This represents a significant
resource burden on the NHS. However
only 1-3% of admitted patients actually
go on to develop life-threatening
intracranial pathology, with the
remainder going home within 48 hours,
having had no intervention other than
observation.7,8,20
Also of concern is the quality of the
observation that patients receive while in
hospital. In a recent retrospective survey
of 200,000 children in the North-East of
England, only 14 children who presented
with a minor head injury required
neurosurgery. However, the recognition
of secondary deterioration was delayed
in all 14 patients, with documented
routine neurological observations in only
one child. Diagnosis of an intracranial
haematoma was made between 6 hours
and 14 days after the head injury, with
a median delay of 18 hours.31
This is not a problem unique to the UK. In
the USA it has been found that only
50% of patients admitted with a minor
head injury had documentation of
neurological observations and for the
majority of these, the frequency of
observations was not sufficient to detect
early neurological deterioration.32 In the
UK, patients with head injury have
historically been observed on non less |
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