We have interpreted the GCS<13 at any time to be those who were knocked out. I
cant think how else to use this rather helpful catch all phrase; at present we
have got our radiologists to follow the gudelines. At first they insisted that
every patient referred for a scan had to have been examined, had "l.o.c"
observations and a "Glasgow score" and have a checklist completed showing
where the patient qualified for a scan under the guidelines. If you think
about it for a moment you will see that none of this was at all difficult. We
simply copied the indications for a scan onto a new piece of paper with
"checklist" on the top and all you need is to satisfy one criterion and you
get the scan. Or to put it more clinically the patient gets the investigation
that you think most apprpriate. The radiologists also agreed that now there
was a "checklist" that any grade of doctor could fill in the checklist and as
the checklist is the passport to the scanner it means that any grade of doctor
can get head scans according to the NICE guidelines.
JP
>>> sri srinivas 11/13/03 09:22am >>>
hi
is anybody actively looking at implementing the nice
guidelines for head injuries. we have started
discussing with our radiology colleagues and there
were some queries on the following points just for
openers, which i am sure will increase the more we
look at implementing it in its entirerity.
1) any idea what <gcs13 at anytime means- does it mean
measured by a healthcare professional?
2) >1 episode of vomiting - especially kids this is
pretty common. and what do folks think of one seizure
post injury with complete recovery in kids requiring
c.t scan
3)any l.o.c - this again is a big bug bear - should
there be a time span- say l.o.c over a minute or so
altho this is not evidence based we do get patients
often with momentary l.o.c say less than a minute. and
pts who are amnesic for 5 minutes or so post injury
might say there were unconscious altho they might not
be.
these are national guidelines and can we interpret and
adapt it locally. what is the consensus?
sri
________________________________________________________________________
Want to chat instantly with your online friends? Get the FREE Yahoo!
Messenger http://mail.messenger.yahoo.co.uk
|