1993-2018
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Nhrc : Twenty Five Years-billion Hopes
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and amnesia) of concern to the clinician
Drug or alcohol intoxication, other injuries, shock, suspected nonaccidental injury, meningism, cerebrospinal luid leak where a scalp
laceration overlies a fracture, or the person's age)
When there is no responsible family member, caregiver or close
friend under whose care the person could be discharged. 'Mild' head
injuries with symptoms such as headache, photophobia, nausea and
vomiting, or amnesia requiring management.
60. What are the discharge or follow up criteria in cases of head
injury?
The patient can be discharged with the follow up advice, if, any of the
following are present (reference as mentioned in previous query)
1.If CT is not indicated on the basis of history and examination, as long
as no other factors that would warrant a hospital admission are
present (drug or alcohol intoxication, concomitant injuries, shock,
suspected non-accidental injury, meningism, cerebrospinal luid
leak) and there are appropriate support structures for safe transfer
to the community and for subsequent care (competent supervision
at home).
2.After normal imaging of the head and the patient has returned to
GCS equal to 15, as long as no other factors that would warrant a
hospital admission are present and there are appropriate support
structures for safe transfer to the community and for subsequent
care (competent supervision at home/prison).
3.After normal imaging of the cervical spine and as long as the patient
has returned to GCS equal to 15 and their clinical examination is
normal, and no other factors that would warrant a hospital
admission are present and there are appropriate support
structures for safe transfer to the community and for subsequent
care (competent supervision at home/prison).
4.Do not discharge patients presenting with head injury until they
have achieved GCS equal to 15, or normal consciousness in infants
and young children as assessed by the paediatric version of the GCS.
5.All patients with any degree of head injury should only be
transferred to their home/prison if it is certain that there is
somebody suitable at home to supervise the patient.
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