This pathway for management of acute head injury addresses assessment, investigation and early management of patients presenting with head injury to an accident and emergency department in an NHS hospital (UK). The guidance is evidence based and draws primarily on a NICE guideline published in June 2003, and a more recent partial update 2007 (see sources). A summary of the evidence on which the guidance is based is provided in the full guideline produced by the UK National Collaborating Centre for Acute Care (see references).
Prepared by Dr Marc Gutenstein FACEM, Consultant Emergency Physician (New Zealand & UK)
The OpenClinical pathway is composed entirely of data and management decisions contained within the NICE guideline and hence involves a dataset that should be considered necessary but not sufficient for planning actual patient care in head injury.The OpenClinical version has not yet been peer reviewed, nor authorised by NICE, and must only be viewed as a technical demonstration.
The guideline offers best practice for the care of all patients who present with a suspected or confirmed traumatic head injury with or without other major trauma. Separate advice is provided for adults and children (including infants) where different practices are indicated. It offers advice on the management of patients with a suspected or confirmed head injury who may be unaware that they have sustained a head injury because of intoxication or other causes. The guideline does not provide advice on the management of patients with other traumatic injury to the head (for example, to the eye or face). It does not address the rehabilitation or long-term care of patients with a head injury but the guideline does explore possible criteria for the early identification of patients who require rehabilitation.