Management of Head Injuries: A Practical Guide for the Emergency Room

Author: David G. Currie
Published: February 2000
Publisher: Oxford University Press
ISBN: 0192630784
Paperback Book
Number of Pages: 196

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Head injuries are commonplace. Although most patients survive, the consequences, both physical and social, can be devastating. The methods of initial assessment and management can have a crucial effect on determining the outcome of the injury, and long-term effects. However, only a minority of head-injured patients are cared for by neurosurgeons. The majority are seen by non-specialists, often junior doctors and nurses, and treated in district hospitals where specialist neurosurgical assistance is unavailable." "New to the second edition are chapters on managing the 'disturbed' head-injured patient, a chapter of special value to nurses (who often have to deal with this difficult task); one on anaesthesia and head injuries has also been added, with other chapters significantly revised to reflect the crucial role played by anaesthetists in head injury management." "Providing practical advice on the early treatment of minor head injuries, and the management of major head injuries, The management of head injuries provides advice that will be essential to both doctors and nurses in ensuring effective treatment of these patients. A wide variety of potential head injuries encountered in an emergency room are covered in this second edition. The first edition was published in 1993. "The purpose is to provide junior doctors working in emergency departments a resource for initial management of the head injury patient when neurosurgical assistance is unavailable. As an emergency medicine resident, I feel this book would be very useful for a medical student or non-emergency trained physician working in an emergency department, and the objectives are certainly worthy. "The book is targeted at junior doctors, which I take to mean medical students and possibly interns. The author, a neurosurgeon from the Aberdeen Royal Infirmary, is certainly a credible authority of head injury management in Great Britain. "The author offers chapters on diagnosis, evaluation, and treatment of closed head, scalp, and cervical spine injuries. He also covers the disturbed patient, transportation, and delayed complications. Multiple diagrams, charts, tables, and x-rays help illuminate the text. "My overall assessment is that a young doctor can get a good introduction to the management of closed head injury from this book, as the author describes concepts such as intracranial bleeds, cervical spine injuries, and basic management techniques. He does not, however, include management of open head injuries such as those caused by firearms, which is a commonly required in urban settings. Again, this is an excellent introduction to the patient with a head injury for a medical student, but the detail required to make this a reference book for emergency physicians in an emergency room is not included. A guide to the emergency treatment of minor head injuries and the management of major head injuries before referral to specialist neurosurgeons, addressed to front-line emergency room doctors, or general doctors in remote areas where specialist attention is not readily available. Among the topics are the initial assessment, radiology, children, delayed complications, and transport.

Table of Contents
1 Introduction 1
2 Initial assessment 15
3 Resuscitation 31
4 Neurological deterioration 45
5 Radiology 65
6 Scalp and skull injuries 81
7 Cervical spine injuries 99
8 Head injuries in children 119
9 Operative surgery 131
10 Anaesthesia in head injuries 147
11 The disturbed head-injured patient 161
12 Delayed complications 169
13 Transporting the head-injured patient 181
Index 191

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