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- Title
Implementing a Routine Screening Program in the Acute Care Setting for Mild Traumatic Brain Injury.
- Authors
Bergeron, Eric; Clas, David; Messier, Daniel; Pintal, Lucie; Mawn, Jennifer; Godbout, Denis; Coallier, Sylvie; Martin, Marcel
- Abstract
Objective: The purpose of this study was to show that systematic screening after blunt head trauma can identify patients with previously unsuspected minor closed head injuries which require further treatment. Patients and Methods: All trauma patients reporting to the emergency department of a regional trauma center following blunt trauma, from April 1999 to March 2001, were systematically evaluated for the possibility of a closed head injury whether or not they required admission. Patients with a documented closed head injury, based on clinical or radiologic evaluation or an initial Glasgow Coma Scale < 14 were excluded. A nurse screened patients using a standardized screening tool, a modification of the Rivermead Questionnaire. Positive cases were further evaluated by a team of neuropsychologists using a selected test battery depending on the patient's complaints, and extended clinical interview. x2 was used to compare groups. Results: Among 724 eligible patients with no suspected head injury after blunt trauma, 202(39%) initially screened positive; 58 refused further investigation. The remaining 144 patients underwent further neuropsychological testing. 120 patients (83%) were tested positive. In the group with positive testing, 48 patients (40%) were referred for rehabilitation on an external basis compared to none in the group with negative testing (p < 0.001). 45 patients (38%) in the group with positive testing and ten patients (42%) in the group with negative testing (p = n.s.) required other treatment such as counseling, psychotherapy or medication. No patients needed neurosurgical consultation. Conclusion: We believe that this study showed the potential utility of systematic screening of blunt head trauma victims. This approach helps to identify a significant number of patients with previously unsuspected minor head injuries who require further treatment.
- Subjects
MEDICAL screening; HEAD injuries; TRAUMA centers; HOSPITAL emergency services; NEUROPSYCHOLOGICAL tests; BLUNT trauma
- Publication
European Journal of Trauma, 2003, Vol 29, Issue 2, p85
- ISSN
1439-0590
- Publication type
Article
- DOI
10.1007/s00068-003-1231-6