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Survey of the management of patients with minor head injuries in hospitals in Sweden

Bellner, Johan LU ; Ingebrigtsen, Tor and Romner, Bertil LU (1999) In Acta Neurologica Scandinavica 100(6). p.355-359
Abstract
OBJECTIVES: Development of guidelines for quality assurance in head injury care has to be based on knowledge about how today's management is organized. To address the need for guidelines in minor head injury (MHI), the authors studied management practice in Sweden. METHODS: We performed a cross-sectional mail survey including all 76 hospitals treating head-injured patients. The questionnaire outlined present management practice in MHI; including routines for clinical and radiological examinations, in-hospital observation, discharge criteria and follow-up. RESULTS: The initial evaluation is frequently performed by inexperienced physicians. The level of consciousness is assessed according to the Swedish Reaction Level Scale or the Glasgow... (More)
OBJECTIVES: Development of guidelines for quality assurance in head injury care has to be based on knowledge about how today's management is organized. To address the need for guidelines in minor head injury (MHI), the authors studied management practice in Sweden. METHODS: We performed a cross-sectional mail survey including all 76 hospitals treating head-injured patients. The questionnaire outlined present management practice in MHI; including routines for clinical and radiological examinations, in-hospital observation, discharge criteria and follow-up. RESULTS: The initial evaluation is frequently performed by inexperienced physicians. The level of consciousness is assessed according to the Swedish Reaction Level Scale or the Glasgow Coma Scale in 96% of the hospitals. Routine computerized tomography is used in 4%. Skull radiography is not routinely performed. Eighty percent of the hospitals discharge selected patients without in-hospital observation and most (93%) offer no routine follow-up. CONCLUSIONS: This survey shows a variation in the management of MHI in hospitals in Sweden. Routines for assessment of consciousness level are satisfactory, but CT scan for detection of skull fracture and early diagnoses of intracranial complications is usually not performed. Guidelines should be based on present routines including decision rules for CT scan. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Neurologica Scandinavica
volume
100
issue
6
pages
355 - 359
publisher
Wiley-Blackwell
external identifiers
  • pmid:10589794
  • scopus:0032731251
ISSN
1600-0404
language
English
LU publication?
yes
id
629146e1-199a-4a8a-b639-534f3c82bf2a (old id 1115910)
date added to LUP
2008-07-08 16:08:46
date last changed
2017-01-01 07:13:15
@article{629146e1-199a-4a8a-b639-534f3c82bf2a,
  abstract     = {OBJECTIVES: Development of guidelines for quality assurance in head injury care has to be based on knowledge about how today's management is organized. To address the need for guidelines in minor head injury (MHI), the authors studied management practice in Sweden. METHODS: We performed a cross-sectional mail survey including all 76 hospitals treating head-injured patients. The questionnaire outlined present management practice in MHI; including routines for clinical and radiological examinations, in-hospital observation, discharge criteria and follow-up. RESULTS: The initial evaluation is frequently performed by inexperienced physicians. The level of consciousness is assessed according to the Swedish Reaction Level Scale or the Glasgow Coma Scale in 96% of the hospitals. Routine computerized tomography is used in 4%. Skull radiography is not routinely performed. Eighty percent of the hospitals discharge selected patients without in-hospital observation and most (93%) offer no routine follow-up. CONCLUSIONS: This survey shows a variation in the management of MHI in hospitals in Sweden. Routines for assessment of consciousness level are satisfactory, but CT scan for detection of skull fracture and early diagnoses of intracranial complications is usually not performed. Guidelines should be based on present routines including decision rules for CT scan.},
  author       = {Bellner, Johan and Ingebrigtsen, Tor and Romner, Bertil},
  issn         = {1600-0404},
  language     = {eng},
  number       = {6},
  pages        = {355--359},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Neurologica Scandinavica},
  title        = {Survey of the management of patients with minor head injuries in hospitals in Sweden},
  volume       = {100},
  year         = {1999},
}