Organisation of care and initial management of severe head injury in Spain: Results of a national survey

6533b7d4fe1ef96bd1261e0f

RESEARCH PRODUCT

Organisation of care and initial management of severe head injury in Spain: Results of a national survey

subject

medicine.medical_specialty Telemedicine Severe head injury Neurosurgery Intensive care specialist Neuroimaging Computed tomography Head trauma 03 medical and health sciences 0302 clinical medicine medicine Craniocerebral Trauma Humans Intensive care medicine Monitoring Physiologic Intracranial pressure Patient Care Team medicine.diagnostic_test business.industry Disease Management 030208 emergency & critical care medicine Emergency department medicine.disease Telemedicine humanities Spain Brain Injuries Health Care Surveys Practice Guidelines as Topic Neurosurgery Medical emergency Intracranial Hypertension Emergency Service Hospital Tomography X-Ray Computed business Surgery Department Hospital 030217 neurology & neurosurgery

description

Abstract Objective The main objective of the study is to obtain knowledge about the organisation of care for severe head trauma as well as the initial management of these patients in Neurosurgical Departments in Spain. Material and method A 22-item questionnaire was designed and sent to 59 Neurosurgical Departments. The aim of the questionnaire was to collect data regarding the general profile of the patients with a severe head injury, the general characteristics of the hospitals, the initial care of these patients, the monitoring techniques used, and the measures used to control Intracranial pressure (ICP). Results Of the 59 Neurosurgical Departments identified, 29 (49.2%) completed the questionnaire. There was a wide variability in the number of patients treated per year between the different departments. The leadership of care often fell (58.6%) on the intensive care specialist. Many (69%) of the departments did not have a neurosurgeon specially dedicated to the management and monitoring of these patients. The initial care in the Emergency department usually fell (51.7%) on the general medicine practitioner. The availability of computed tomography (CT) was universal. The use of telemedicine was highly variable. ICP monitoring was performed on more than 75% of patients in most (89.7%) of departments, but there was limited use of other monitoring techniques. Most Departments followed the recommendations of the Brain Trauma Foundation (BTF) guidelines for the control of ICP. Conclusions The organisation of care and the initial management of severe head trauma in Spain is very similar to its neighbouring countries. However, there are shortcomings, such as low participation by a neurosurgeon in the initial management of these patients, insufficient use of telemedicine, and the low implementation of certain brain monitoring techniques (SjO 2 , PtiO 2 , and Doppler).

year	journal	country	edition	language
2016-09-01	Neurocirugía (English Edition)

https://doi.org/10.1016/j.neucie.2017.06.004