A&E are the team who look after head injury in Scarborough. We always have been
and with the Galasko report it looks like the rest of you will join us.
Our nearest trauma surgeons who deal with heads are 90 plus minutes away on
a good day.
If normal range anticoag then CT for any symptoms. CT is requested Consultant
to Consultant.
Our overall positive CT rate (all patients not just warfarin) is 40%. So far
my Warfarin patients have not revealed any lesion unless it was clinically obvious
that "something was up" so I would like to improve my selection, but given the
low numbers of these patients here, I will play cautious for now
>Andyvolans said:
>
>> "My bottom line is Head injury plus warfarin, check INR. If elevated out
of
>treatment range, admit under medics for control."
>
>Presumably you are referring to patients with GCS 15 and no other symptoms
or
>signs.
>
>Are the "Medics" happy to take a patient with a higher risk of intracranial
>bleeding under their care on that ground? Would it not make more sense to refer
>to the trauma surgeons (or the team that normally deals with head injuries)
>for neuro-obs. and maybe let them consult the Medics to control the INR?
>
>
>>If normal treatment range, any symptoms need CT.
>
>So, do you observe/admit to be ready to scan should they develop any ominous
>sign?
>
>M. Della Corte
>Staff Grade ED
>Oxford
>
>
>
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