The Head Injury Retrieval Trial (HIRT): a single-centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics only.

Background: Advanced prehospital interventions for severe brain injury remains controversial. No previous randomised trial has been conducted to evaluate additional physician intervention compared with paramedic only care.

Methods: Participants in this prospective, randomised controlled trial were adult patients with blunt trauma with either a scene GCS score <9 (original definition), or GCS<13 and an Abbreviated Injury Scale score for the head region ≥3 (modified definition).

The study protocol for the Head Injury Retrieval Trial (HIRT): a single centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics.

Background: The utility of advanced prehospital interventions for severe blunt traumatic brain injury (BTI) remains controversial. Of all trauma patient subgroups it has been anticipated that this patient group would most benefit from advanced prehospital interventions as hypoxia and hypotension have been demonstrated to be associated with poor outcomes and these factors may be amenable to prehospital intervention. Supporting evidence is largely lacking however.

Risk factors for complications during intracranial electrode recording in presurgical evaluation of drug resistant partial epilepsy.

Background: Intracranial electrode monitoring is still required in epilepsy surgery; however, it is associated with significant morbidity.

Objective: To identify risk factors associated with complications during invasive intracranial EEG monitoring.

Materials And Methods: Retrospective study of all patients undergoing invasive monitoring at Westmead between 1988-2004.

Protein S-100 and neuropsychological functioning following severe traumatic brain injury.

Primary Objective: To examine the relationship between serum concentrations of protein S-100beta and neuropsychological functioning following severe traumatic brain injury.

Design: Matched control group.

Methods: Blood samples were taken within 12 hours of injury and then daily up to 7 days post-injury (n=23).

Cancellation of operations on the day of intended surgery at a major Australian referral hospital.

Objective: To establish the rate of and reasons for cancellations of surgery on the scheduled day in an Australian hospital.

Design: Prospective survey.

Setting: Major metropolitan tertiary hospital, 13 May to 15 November 2002.

Level of prehospital care and risk of mortality in patients with and without severe blunt head injury.

Objectives: To determine the association between mortality and the level of prehospital care in severely injured blunt trauma patients with or without severe head injury.

Method: Retrospective review of 2010 severe blunt trauma patients (injury severity score (ISS) >15) with or without severe head injury in a tiered trauma system involving ambulance officers (basic life support (BLS) and advanced life support (ALS)) and physicians, and a Level 1 trauma centre.

Results: After adjusting for age, type of head injury, glasgow coma scale score (GCS), systolic blood pressure, ISS and prehospital time, intensive care unit (ICU) admission modified the association between level of prehospital care and mortality.