Management of craniocerebral trauma in Emergency Department practice

Introduction: Head trauma patients constitute 25-40% of all trauma victims. Despite such a significant prevalence of the above pathology, still many controversies exist regarding both the diagnostic procedure and criteria for admission especially within operating range of hospital admission room (AR) or hospital emergency department (ED). Objective: our objective is to present a proposal of algorithm for management of a patient with head and/or craniocerebral trauma (CCT) for emergency physicians on call working in AR or ED, using available diagnostic methods. Material: Management of 715 patients with CCT treated in the ED of St. Barbara Regional Specialistic Hospital No. 5 in Sosnowiec was analyzed. Performed diagnostic procedures such as diagnostic imaging by means of head and/or spine CT scan, skull and/or spine X-ray and the ED physicians’ demanour were evaluated. Results: CCT patients constituted 33% of all trauma patients getting into the ED. In this group 70% of the patients suffered from mild or moderate head trauma and the remaining 30% referred to patients with severe CCT and/or multiorgan trauma. There were twice as many man as women among the patients. Conclusions: On the basis of analyzed variables a proposal of algorithm for management of CCT patients within the ED has been presented.