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Call for clinicians to advise head injury patients at point of discharge

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Nurses and doctors should give verbal and printed advice to patients with any type of head injury, who are discharged from an emergency department or observation ward.

Any advice should be accessible and appropriate to the patient’s age, said the National Institute for Health and Care Excellence in updated guidance on head injury.

The new document replaces a version published in September 2007.

NICE also warned that time was “of the essence” when treating head injuries to avoid potentially serious complications, including disability or death.

Professor Mark Baker, director of the Centre for Clinical Practice at NICE, said: “Although a person may appear fine at first, it is not uncommon for symptoms of a head injury to affect them some hours after the trauma took place.”

Mark Baker

Mark Baker

Key changes in the guidance include recommending that ambulance crews should take head injury patients straight to a hospital with resuscitation facilities, where doctors and nurses can investigate and treat their injuries.

Children and adults who have experienced a head injury and begin to show signs that it may be serious or potentially life-threatening – such as seizures or loss of consciousness – should be given a CT brain scan within one hour.

Others should be scanned within four to eight hours of their injury, depending on its severity, the NICE guidance said.

A specialist who trained in safeguarding should be involved in checking any patient with a head injury presenting to A&E.

Peter McCabe, chief executive of the brain injury association Headway, said: “We welcome these updated guidelines, particularly as they reinforce the need for high-quality written discharge information to be given to patients upon leaving hospital following a head injury.”

Peter McCabe

Peter McCabe

The institute noted that it was the most common cause of death and disability in people up to the age of 40 and 1.4 million people attend accident and emergency in England and Wales each year with a recent head injury.

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