What's the procedure in A&E, how do medics decide when a scan is necessary? Is there a standard procedure?
Thanks. 🙂
[s]Roughly but not fool proof.
Age.
Point of impact
Injury
Symptoms
Medical history[/s]
You know what it's easier to copy a guideline.
Adults
1.4.7 For adults who have sustained a head injury and have any of the following risk factors, perform a CT head scan within 1 hour of the risk factor being identified:GCS less than 13 on initial assessment in the emergency department.
GCS less than 15 at 2 hours after the injury on assessment in the emergency department.
Suspected open or depressed skull fracture.
Any sign of basal skull fracture (haemotympanum, 'panda' eyes, cerebrospinal fluid leakage from the ear or nose, Battle's sign).
Post-traumatic seizure.
Focal neurological deficit.
More than 1 episode of vomiting.
A provisional written radiology report should be made available within 1 hour of the scan being performed. [new 2014]
1.4.8 For adults with any of the following risk factors who have experienced some loss of consciousness or amnesia since the injury, perform a CT head scan within 8 hours of the head injury:
Age 65 years or older.
Any history of bleeding or clotting disorders.
Dangerous mechanism of injury (a pedestrian or cyclist struck by a motor vehicle, an occupant ejected from a motor vehicle or a fall from a height of greater than 1 metre or 5 stairs).
More than 30 minutes' retrograde amnesia of events immediately before the head injury.
A provisional written radiology report should be made available within 1 hour of the scan being performed. [new 2014]
Excellent, thank you Drac. 8)
Drac's source is Nice guidelines, original can be found by googling NICE head injury guidelines. Any loss of consciousness or post injury symptoms?
Thanks Tom. My son didn't lose consciousness but he came down hard, as did many others in the (crit) bunch sprint. They were all taken to A&E, he's in a lot of pain (not his head) and wearing a splint. No scan was done, just obs. I'm probably being paranoid.
The NHS Wales test is I think the projectile vomiting of NHS carrot and coriander soup. I once hit my head so hard that I compression fractured some vertebra - about 18 hours latter after I lost my soup I was checked out for and found to have concussion. CG - can you keep soup down?
I'm probably being paranoid.
worth a read
The race should really have a concussion protocol in place. EWS went with this one (just scanned it) and the briefings were you need a docs note before you return to racing (even the next event)
Nipper - it's not me this time. Your experience sounds awful.
Mike - thanks, will take a look. I lost consciousness when I hit my head and grateful that I was scanned. A friend was semi-conscious and A&E didn't scan her, she has some residual neuro damage.
There was 60 racing in the crit, 3 ambulances took the injured including the concussed and those with broken bones.
Symptoms can develop for up to 14 days afterwards apparently. I'll send him the link, definitely a good read.
Nipper99 - MemberÂ
I once hit my head so hard that I compression fractured some vertebra
Ditto. Not sure if they did a soup test though, I have no memory of it. Believe they'd suspected back break so stretchered, spinal/neck brace etc and they did various CT scans checking not just spine but head for brain injury. Apparently they had to knock me out as I was being "uncooperative" 😆
[quote=cinnamon_girl]
There was 60 racing in the crit, 3 ambulances took the injured including the concussed and those with broken bones. If only the NHS wasn't having to deal with this type of "self-inflicted" injury, it would have more money to look into things like Lyme Disease eh? 😆
Oi scotroutes, you cheeky beggar! Nah, NHS just waiting to roll over for when Pharma comes up with a super-expensive drug that'll be handed out like sweeties. 😉
I managed to knock some sense into myself on one of our WNR and even though i didnt know what month it was, or that my wife was pregnant they said i was ok as i hadn't fallen from 2m and was ok otherwise.
oh the fun....
so basically just look after them, if your worried go back!!
c_g - do you have any more news?
