White Rose University Consortium logo
University of Leeds logo University of Sheffield logo York University logo

Audit of head injury management in Accident and Emergency at two hospitals: implications for NICE CT guidelines

Miller, L., Kent, R.M. and Tennant, A. (2004) Audit of head injury management in Accident and Emergency at two hospitals: implications for NICE CT guidelines. BMC Health Services Research, 4 (7). ISSN 1472-6963

Available under licence : See the attached licence file.

Download (250Kb)



The National Institute for Clinical Excellence (NICE) has produced guidelines on the early management of head injury. This study audits the process of the management of patients with head injury presenting at Accident and Emergency (A&E) departments and examines the impact upon resources of introducing NICE guidelines for eligibility of a CT scan.


A retrospective audit of consecutive patients of any age, presenting at A&E with a complaint of head injury during one month in two northern District General Hospitals forming part of a single NHS Trust.


419 patients presented with a median age of 15.5 years, and 61% were male. 58% had a Glasgow Coma Score (GCS) recorded and 33 (8%) were admitted. Only four of the ten indicators for a CT scan were routinely assessed, but data were complete for only one (age), and largely absent for another (vomiting). Using just three (incomplete) indicators showed a likely 4 fold increase in the need for a CT scan.


The majority of patients who present with a head injury to Accident and Emergency departments are discharged home. Current assessment processes and associated data collection routines do not provide the information necessary to implement NICE guidelines for CT brain scans. The development of such clinical audit systems in a busy A&E department is likely to require considerable investment in technology and/or staff. The resource implications for radiology are likely to be substantial.

Item Type: Article
Copyright, Publisher and Additional Information: © 2004 Miller et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
Institution: The University of Leeds
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds)
The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Musculoskeletal Disease (Leeds)
Depositing User: Repository Officer
Date Deposited: 13 Mar 2006
Last Modified: 05 Jun 2014 21:39
Published Version: http://www.biomedcentral.com/1472-6963/4/7
Status: Published
Refereed: Yes
Identification Number: 10.1186/1472-6963-4-7
URI: http://eprints.whiterose.ac.uk/id/eprint/68

Actions (repository staff only: login required)