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This month we publish four papers on head injuries, two of them an analysis of the impact of the NICE head injury guidelines issued in 2003. Hassan and colleagues report that implementation of the guidelines led to a significant increase in CT usage and a reduction in skull x-ray and admission rates. Qureshi et al look at the human resource (nurse) implications of performing head injury observations. Clinical decision rules are increasingly used to help clinicians treat patients. The team from Portland Oregon describe a new rule to help identify patients with blunt traumatic brain injury who need urgent ‘trauma centre’ care. Finally Kerr and his colleagues from Scotland audited head injury management after the Scottish Intercollegiate Guidelines Network guidelines were introduced in 2000.
See p 845, 861, 874, and 850
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