@article {Ashkenazi550, author = {Itamar Ashkenazi and Jacob Haspel and Ricardo Alfici and Boris Kessel and Tawfik Khashan and Meir Oren}, title = {Effect of teleradiology upon pattern of transfer of head injured patients from a rural general hospital to a neurosurgical referral centre}, volume = {24}, number = {8}, pages = {550--552}, year = {2007}, doi = {10.1136/emj.2006.044461}, publisher = {British Association for Accident and Emergency Medicine}, abstract = {Objective: To assess the effect of teleradiology upon the need for transfer of head injured victims requiring hospitalisation but referred initially to a rural level 2 trauma centre without neurosurgical capacity. Methods: Head injured patients requiring hospitalisation, admitted to a rural level 2 trauma centre between August 2003 and August 2005, were identified. A digitalised copy of the computed tomographic (CT) scan was transferred to the neurosurgical referral centre via teleradiology and was available for review by the neurosurgeon on-call, who then, together with the trauma surgeon in the rural level 2 trauma centre, decided whether to transfer the patient to the neurosurgical referral centre. Results: Of 209 trauma victims with neurosurgical pathology in need of hospitalisation, 126 (60.2\%) were immediately transferred while 83 (39.7\%) of the patients were hospitalised in the rural level 2 trauma centre for observation. Two (2.4\%) failed the intent to treat locally. One patient, suffering from multi-trauma, was stabilised after damage control laparotomy only to succumb to an enlarging epidural haematoma. Another patient was transferred 2 days after admission because of difficulty in clinical evaluation due to a previously existing neurological disorder, but no active treatment was necessary. All other 81 patients recovered uneventfully. Conclusions: Selective head injured patients with pathological CT scan may be safely managed in level 2 trauma centres. A committed trauma team in the rural trauma centre, neurosurgical consultation and availability of a teleradiology system are requisites. Currently existing transfer criteria should be carefully re-evaluated.}, issn = {1472-0205}, URL = {https://emj.bmj.com/content/24/8/550}, eprint = {https://emj.bmj.com/content/24/8/550.full.pdf}, journal = {Emergency Medicine Journal} }