Yep, you got me there. I should know better and offer a risk based estimate,
'completely safe' just sounds more attractive. I suppose another question
that we need answering (in the UK) is which option is more cost effective:
observation or 'CT and street'. I guess both are pretty safe for minor head
injuries. I think a health economist is probably the best person to ask
about this since this could get quite complex.
Unprovoked
Adrian
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of Paul Bailey
Sent: Tuesday, August 19, 2003 6:46 AM
To: [log in to unmask]
Subject: Re: NOT VERY NICE head injury guidelines
Renee and listfolk,
those of us who aren't UK based do this all the time! Every time this
subject
comes up, on of the UK EPs will bring up the concept of late haemorrhage and
give a reference to the case reports.
And, Adrian, you should know better than to ask that something in Medicine
be
proven to be *completely* safe - is there such a thing anywhere, ever? The
question should be - what are the risks and benefits of early discharge
after
a normal head CT in minor head injury.......
Provocatively,
Paul
----- Original Email -----
From: Renee Nilan <[log in to unmask]>
To: [log in to unmask]
Date: 19-Aug-2003 13:28
Subject: Re: NOT VERY NICE head injury guidelines
> In a message dated 8/18/2003 6:31:07 AM Eastern Daylight Time,
> [log in to unmask] writes:
>
> > I think the next challenge in this field is to show that is completely
safe
> > to discharge somebody after a normal CT scan who is orientated. Until
then
> > we cannot really justify or (afford?) these guidelines.
> > Adrian
>
>
>
> What makes you think that it isn't safe to discharge an oriented patient
> after a negative CT scan? Of course you may have a patient develop a
subdural up
> to a few weeks out, however, observation in the hospital will not prevent
this.
> Let caregivers know the risk and what to watch for in the patient.
>
> I agree that you cannot afford to perform a CT scan on a patient with a
> normal exam whom you are going to admit. What is the purpose of the study
in
this
> case?
>
> Renee
>
________________________________________________________________________
This email has been scanned using the CleanPort MEF antivirus
system. Funded for members by the Doctors.net.uk Bulletin service
How does this protect me? http://www.Doctors.net.uk/qualityemail
________________________________________________________________________
|