`Things that go bump...` Head injuries at the Royal Alexandra Children’s Hospital (RACH), Brighton.

 
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C Doré MSc*, C Bevan MB ChB, MRCPCH, FRCP**, M Lazner MB ChB***, MMedSc, MRCPCH****
Brighton & Sussex Medical School*, Brighton & Sussex Medical School**, Brighton & Sussex Medical School ***, Brighton & Sussex Medical School ****
Email
bsms3375@uni.bsms.ac.uk
Background
Since June 2015, if a time critical pediatric neurosurgical emergency is diagnosed at RACH, they have immediate access to the RSCH adult neurosurgical team. Prior to June, these children had to be transferred to the nearest neurosurgical unit, thereby delaying urgent surgery.
Aim
The aim of this study was to produce a database in order to review the epidemiology of head injuries and their management, in children who presented to our emergency departments (ED).
Methods
This was a retrospective review of patients aged under 17 who were seen in either Royal Alexandra Children’s Hospital (RACH), or Royal Sussex County Hospital (RSCH) ED’s, who required admission or transfer, or who died. The study period was between the 1st of July 2015 0:00, to the 30th of June 2016, 23:59.
Results
Two percent of the 4,862 patients analysed sustained a head injury of which 62% were males and 16% of the children were under the age of one. Eight percent of the study population were known to social services. The most common mechanism of injury was a fall of less than 2 metres. Thirty-nine percent of patients had a head CT scan. The average time from arrival to head CT scan was 3 hours and 3 minutes. The two children who had neurosurgery at RSCH had medical conditions that were relevant to their head injury. The average time from arrival to the start of the neurosurgical procedure was 1 hour and 34 minutes.
Conclusion
RACH successfully managed the majority of head injuries, however, our imaging protocols may require improvement in order to comply with NICE guidance.
 
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MSc D C, FRCP M C M B C, ChB M L M, MRCPCH M.. Available From : http://www.pediatriconcall.com/conference/abstract/37/view/853
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