Emergency Department Time Course for Mild Traumatic Brain Injury Workup

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Edward A.,Huff,J. Stephen,Loparo,Mae,Naunheim,Rosanne S., Michelson (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: Introduction: Mild traumatic brain injury (mTBI) is a common cause for visits to the emergency department(ED). The actual time required for an ED workup of a patient with mTBI in the United States is not wellknown. National emergency medicine organizations have recommended reducing unnecessary testing,including head computed tomography (CT) for these patients.10Methods: To examine this issue, we developed a care map that included each step of evaluation of mTBI(Glasgow Coma Scale Score 13-15) -- from initial presentation to the ED to discharge. Time spent at eachstep was estimated by a panel of United States emergency physicians and nurses. We subsequentlyvalidated time estimates using retrospectively collected, real-time data at two EDs. Length of stay (LOS)time differences between admission and discharged patients were calculated for patients being evaluatedfor mTBI.Results: Evaluation for mTBI was estimated at 401 minutes (6.6 hours) in EDs. Time related to head CTcomprised about one-half of the total LOS. Real-time data from two sites corroborated the estimate ofmedian time difference between ED admission and discharge, at 6.3 hours for mTBI.Conclusion: Limiting use of head CT as part of the workup of mTBI to more serious cases may reduce timespent in the ED and potentially improve overall ED throughput.

Additional Information

Publication

Other

Language: English

Date: 2018

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