The management of minor head trauma (GCS 15-13) across a Trauma Network.

Objectives: To determine the variations in the management of patients with minor head injuries across a Trauma Network.

Methods: An 18-point questionnaire covering aspects of hospital care and follow-up of patients with minor head injuries was sent out to 19 wards in 10 different trauma units within our network.

Results: Fifty-eight percent of wards routinely admitting patients with minor head injuries have no management protocol in place. Mild head injury patients stay for 24-48 h as in-patients. Fifty percent of wards use GCS as the only assessment tool. Seventy-four percent of wards give post-head injury advice to their discharged patients with mild head injuries, but only 26% follow their patients up locally and 16% refer minor head injury patients to the specialist neurotrauma clinic. Twenty one percent of wards give information to their head injury patients regarding supporting organisations and charities. Seventy-four percent of ward staff report being confident in looking after head injury patients. All wards would welcome a head injury study day or an in-house education event.

Conclusion: Management of minor head injury patients in trauma units should be standardised and neurosurgical units within Major Trauma Centres (MTC) need to lead in protocol based management of these patients across their network. NICE currently provide guidance detailing local management of head injuries not requiring immediate admission to the MTC. We believe it is the role of the neurosurgical centre to work with trauma units and provide guidelines and standards of practice to ensure optimal management of this vulnerable population group. In addition, the neuroscience centre has a role in ensuring staff education and on-going professional development across Trauma Networks.