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Paper| Volume 28, ISSUE 7, P427-431, September 1997

Secondary insults during the interhospital transfer of head-injured patients: an audit of transfers in the Mersey Region

  • Laurence T Dunn
    Correspondence
    Requests for reprints should be addressed to: Dr L. T. Dunn, Southern General Hospital, Department of Neurosurgery, Institute of Neurological Sciences, Glasgow, Scotland, UK.
    Affiliations
    Department of Neurosurgery, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK
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DOI:https://doi.org/10.1016/S0020-1383(97)00051-X
Secondary insults during the interhospital transfer of head-injured patients: an audit of transfers in the Mersey Region
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      Abstract

      To asses the incidence of secondary insults and unidentified extracranial injuries a prospective audit of 50 head-injury transfers to a regional neurosurgical unit using a standardized assessment proforma was undertaken. There was wide variability in the quality of transfers. Six per cent of the group were hypoxic on arrival and 15 per cent were hypotensive. In the patients with multiple injuries, 29 per cent had inadequately diagnosed or managed injuries when they arrived. A comparison of this cohort of patients with previous studies is presented. As a result of the audit a set of transfer and referral guidelines have been drawn up and, following distribution of the guidelines to our referring hospitals, a further cohort of patients will be audited.
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      References

        • Mendelow A.D
        • Teasdale G
        • Jennett B
        • et al.
        Risks of intracranial haematoma in head injured adults.
        BMJ. 1983; 287: 1173
        • Jennett B
        • MacMillan R
        Epidemiology of head injury.
        BMJ. 1981; 282: 101
        • Reilly P.L
        • Graham D.I
        • Adams J.H
        • Jennett B
        Patients with head injury who talk and die.
        Lancet. 1975; ii: 375
        • Anderson I.D
        • Woodford M
        • DeDombal F.T
        • Irving M
        Retrospective study of 1000 deaths from injury in England and Wales.
        BMJ. 1988; 296: 1305
        • Jeffreys R.V
        • Jones J.J
        Avoidable factors contributing to the death of head injury patients in general hospitals in Mersey Region.
        Lancet. 1981; ii: 459
        • Gentleman D
        • Jennett B
        Audit of transfer of unconscious head-injured patients to a neurosurgical unit.
        Lancet. 1990; 335: 330
        • Andrews P.J.D
        • Piper I.R
        • Dearden N.M
        • Miller J.D
        Secondary insults during intrahospital transport of head-injured patients.
        Lancet. 1990; 335: 327
        • Gentleman D
        • Jennett B
        Hazards of inter-hospital transfer of comatose head-injured patients.
        Lancet. 1981; 17: 853
        • Gentleman D
        Causes and effects of systemic complications among severely head injured patients transferred to a neurosurgical unit.
        Int Surg. 1992; 77: 297
        • Rose J
        • Valtonen S
        • Jennett B
        Avoidable factors contributing to death after head injury.
        BMJ. 1977; ii: 615
        • Jennett B
        • Carlin J
        Preventable mortality after head injury.
        Injury. 1978; 10: 31
        • Mendelow A.D
        • Karmi M.Z
        • Paul K.S
        • et al.
        Extradural haematoma: effect of delayed treatment.
        BMJ. 1979; 1: 1240
        • Seelig J.M
        • Becker D.P
        • Miller J.D
        Traumatic acute subdural haematoma. Major mortality reduction in comatose patients treated within four hours.
        N Engl J Med. 1981; 304: 1511
        • Teasdale G
        • Galbraith S
        • Murray L
        • et al.
        Management of traumatic intracranial haematoma.
        BMJ. 1982; 285: 1695
        • Lambert S.M
        • Willett K
        Transfer of multiply injured patients for neurosurgical opinion: a study of the adequacy of assessment and resuscitation.
        Injury. 1993; 24: 333
        • Vyvyan H.A.L
        • Kee S
        • Bristow A
        A survey of secondary transfers of head injured patients in the south of England.
        Anaesthesia. 1991; 46: 728
        • Marsh H
        • Maurice-Williams R.S
        • Hatfield R
        Closed head injuries: where does delay occur in the process of transfer to neurosurgical care?.
        Br J Neurosurg. 1989; 3: 13
        • Runcie C.J
        • Reeve W
        • Reidy J
        • Wallace P.G.M
        Secondary transport of the critically injured adult.
        Clin Intensive Care. 1991; 2: 217
        • Bion J.F
        • Wilson I.H
        • Taylor P.A
        Transporting critically ill patients by ambulance: audit by sickness scoring.
        BMJ. 1988; 296: 170
        • Ridley S
        • Carter R
        The effects of secondary transport on critically ill patients.
        Anaesthesia. 1989; 44: 822
        • Hope A
        • Runcie C.J
        Inter-hospital transport in the critically ill adult.
        Brit J Intensive Care. 1993; 3: 187
        • Runcie C.J
        • Reeve W.R
        • Wallace P.G.M
        Preparation of the critically ill for interhospital transfer.
        Anaesthesia. 1992; 47: 327
        • Reeve W.G
        • Runcie C.J
        • Reidy J
        • Wallace P.G.M
        Current practice in transferring critically ill patients among hospitals in the West of Scotland.
        BMJ. 1990; 300: 85
        • Wright I.H
        • McDonald J.C
        • Rogers P.N
        • Ledingham I.Mc.A
        Provision of facilities for secondary transport of seriously ill patients in the United Kingdom.
        BMJ. 1988; 296: 543
        • Gentleman D
        Preventing secondary brain damage after head injury: a multidisciplinary challenge.
        Injury. 1990; 21: 305
        • Committee on Trauma
        Head trauma.
        in: Advanced Trauma Life Support Student Manual. American College of Surgeons, Chicago1989: 131 (Ch. 6)
        • Gentleman D
        • Dearden M
        • Midgley S
        • Maclean D
        Guidelines for resuscitation and transfer of patients with serious head injury.
        BMJ. 1993; 307: 547
        • Group of neurosurgeons
        Guidelines for initial management after head injury.
        BMJ. 1984; 288: 983

      Article info

      Publication history

      Accepted: March 19, 1997

      Identification

      DOI: https://doi.org/10.1016/S0020-1383(97)00051-X

      Copyright

      © 1997 Published by Elsevier Inc.

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