Original Title: Guía de práctica clínica sobre el manejo del traumatismo craneoencefálico en el ámbito extra e intrahospitalario de la CAPV

Authors' objectives: To provide a practical reference instrument based on the best evidence available so far, in order to help to reduce the variability factor in the treatment of patients with head injury and improve the quality of care and distribution of resources.

Authors' results and conclusions: Questions to be answered ◗ How should the initial assessment and classification of patients who have suffered a head injury be made? ◗ What is the immediate care given to patients who have suffered a head injury? ◗ What are the criteria for transferring patients with head injury to a hospital centre? ◗ What kind of hospital should patients with head injury be transferred to? ◗ What are the criteria for using the Advanced Life Support when transferring patients with head injury to a hospital centre? ◗ On which patients who have suffered a head injury should a skull CAT be performed? ◗ When a CAT is appropriate to perform, with what urgency should this be done? ◗ When should a cervical spine X-ray be done in patients who have suffered a head injury? ◗ When should a cranium X-ray be done in patients who have suffered a head injury? ◗ What are the observation and/or hospital admission criteria in patients who have suffered a head injury? ◗ What are the signs of neurological deterioration that indicate the need for an urgent reassessment of patients with head injury? ◗ When should the neurosurgery service be consulted in the case of patients who have suffered a head injury?

Authors' recommendations: These guidelines present 34 recommendations relating to the assessment and initial classification of patients with head injury, immediate care, criteria for transferring to a hospital centre, the type of hospital to which these patients must be transferred, criteria for performing skull Computerized Axial Tomography (CAT), X-rays of the cervical spine, criteria for observation and/or admission to hospital and indications for consulting the neurosurgery service.

Authors' methods: Adaptation-updating of Clinical Practice Guidelines (CPG) in line with the Osteba evaluation report “Description of the elaboration of a clinical practice guideline for asthma in the Autonomous Community of the Basque Country by means of a mixed method of adaptation-development-actualization” drawn up by Etxeberria A. et al. The levels of recommendation are based on the Oxford CMBE classification. SEARCH STRATEGY: Scientific databases (Medline, Cochrane Library) and electronic records of clinical practice guidelines. INCLUSION CRITERIA: High-quality CPGs relating to the extrahospital and initial hospital handling of head injury, selected in accordance with the AGREE evaluation instrument and published between 1998 and 2004. Articles published between 2002-2005 relating to initial evaluation, hospital referral criteria, diagnostic tests and criteria for the admission and/or observation of patients with head injury. EXCLUSION CRITERIA: CPGs relating exclusively to the hospital treatment of severe head injury, and guidelines based on or adapted from others.

Project Status: Completed

Year Published: 2007

URL for published report: https://www.euskadi.eus/contenidos/informacion/osteba_publicaciones/es_osteba/adjuntos/gpc_07-2%20traumatismo%20cranoencef%C3%A1lico.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p><BR/>Basque Office for Health Technology Assessment, Health Department Basque Government (OSTEBA)</p>