Should transient loss of consciousness in blunt head trauma be a pre-hospital trauma triage criterion?

B. Zane Horowitz, Onna J. Earle

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

The objective of this study was to evaluate pre-hospital triage of patients with an isolated brief loss of consciousness (LOC) to a regional trauma center (RTC). Data from a 6-month period were retrospectively reviewed from an existing pre-hospital data collection set. Patients were included if either they or a witness claimed a LOC, but they had regained consciousness to at least a Glasgow Coma Score (GCS) > 13 by the time the paramedics arrived. Endpoints for need for trauma center services included positive head computed tomography (CT) scan, the occurrence of emergency non-orthopedic surgery in < 6 h, admission to a surgical intensive care unit (ICU), or a length of stay (LOS) greater than 3 days for surgical evaluation. There were 655 complete records available for 275 cases of vehicular trauma and 380 cases of non-vehicular trauma. There were 170 (62%) patients in the vehicular group, and 287 (76%) in the non-vehicular group evaluated in the emergency department and discharged. In the vehicular group, only one (0.4%) patient required operative intervention in less than 6 h, three (1.1%) had a positive head CT scan, 10 (3.6%) were admitted to a surgical ICU, and four (1.5%) had a LOS > 3 days. In the non-vehicular trauma group, only one (0.3%) had surgery in < 6 h, eight (2.1%) had a positive CT scan, six (1.6%) were admitted to a surgical ICU or had a LOS > 3 days. Overall, 19 (2.9%, CI 0.018-0.045) patients met any one of the end-point criteria for trauma center utilization; however, only one patient (0.2% CI < 0.0001-0.008) required immediate neurosurgical intervention. Transient LOC, in the absence of any other American College of Surgeons (ACS) trauma triage criteria, triaged 97% of patients to a trauma center, who did not require trauma center services based on our criteria.

Original languageEnglish (US)
Pages (from-to)381-386
Number of pages6
JournalJournal of Emergency Medicine
Volume21
Issue number4
DOIs
StatePublished - Dec 18 2001

Keywords

  • Glasgow Coma Scale
  • Head trauma
  • Loss of consciousness
  • Trauma center
  • Triage

ASJC Scopus subject areas

  • Emergency Medicine

Fingerprint Dive into the research topics of 'Should transient loss of consciousness in blunt head trauma be a pre-hospital trauma triage criterion?'. Together they form a unique fingerprint.

  • Cite this