You will see an awful lot of patients with head injury. A lot of these patients will also be intoxicated. A lot of the time, serious head injuries are very obvious but there are some real perils and pitfalls in the assessment and management of what has been called “minor head injury”. The severe traumatic brain injury getting intubated in resus will not be covered.
In MMUH we have an admission pathway for those with minor head injury. These patients are admitted under the ED Consultant on call, the night time Registrar should be aware and the patient flagged at morning handover. Please see our Pathways section for more information.
Some key messages for practicing in MMUH
do not discharge someone who is drunk. They do not ALL need CT, but they do need an assessment when sober
always consider what the reason is that they had their head injury? Did they seize or have a syncopal episode?
many of the IV drug users are on daily innohep for DVTs and will not volunteer this unless asked specifically.