Elsevier

The Lancet

Volume 335, Issue 8685, 10 February 1990, Pages 327-330
The Lancet

CLINICAL PRACTICE
Secondary insults during intrahospital transport of head-injured patients

https://doi.org/10.1016/0140-6736(90)90614-BGet rights and content

Abstract

Secondary pathophysiological insults occurring after injury have been prospectively assessed in 50 head-injured patients who required intrahospital transfer. 35 patients were transported from the intensive care unit (ICU) and 15 from the accident and emergency department. Physiological variables were recorded every minute in the four hours before transfer (ICU group only), during the move, and for four hours afterwards. Pretransfer insults were predictive of further insults during and after transport. There was significant correlation between increased frequency of insults post-transfer (compared with pretransfer) and high injury severity score. A greater proportion of the patients transported from the emergency department had secondary injuries post-transfer. Adequate resuscitation before moving the patient, especially in patients with multiple injury, is important.

References (17)

  • D. Gentleman et al.

    Hazards of inter-hospital transfer of comatose head-injured patients

    Lancet

    (1981)
  • Di Graham et al.

    Ischaemic brain damage is still common in fatal non-missile head injury

    J Neurol Neurosurg Psychiatry

    (1989)
  • Jd Miller et al.

    Early insults in the injured brain

    JAMA

    (1978)
  • Jd Miller et al.

    Further experience in the management of severe head injury

    J Neurosurg

    (1981)
  • Ym Kohi et al.

    Extracranial insults and outcome in patients with acute head injury-relationship to the Glasgow Coma Scale

    Injury

    (1984)
  • G. Waddell et al.

    Effects of ambulance transport in critically ill patients

    Br Med J

    (1975)
  • Jf Bion et al.

    Validation of a prognostic score in critically ill patients undergoing transport

    Br Med J

    (1985)
  • Wa Knaus et al.

    APACHE II: a severity of disease classification system

    Crit Care Med

    (1985)
There are more references available in the full text version of this article.

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