Emergency Department Time Course for Mild Traumatic Brain Injury Workup
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 well known. National emergency medicine organizations have recommended reducing unnecessary testing, including head computed tomography (CT) for these patients.10.
METHODS: 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 each step was estimated by a panel of United States emergency physicians and nurses. We subsequently validated 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 evaluated for mTBI.
RESULTS: Evaluation for mTBI was estimated at 401 minutes (6.6 hours) in EDs. Time related to head CT comprised about one-half of the total LOS. Real-time data from two sites corroborated the estimate of median 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 time spent in the ED and potentially improve overall ED throughput.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2018 |
|---|---|
| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
|---|---|
| Enthalten in: |
The western journal of emergency medicine - 19(2018), 4 vom: 16. Juli, Seite 635-640 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Michelson, Edward A [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 04.09.2018 Date Revised 18.03.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.5811/westjem.2018.5.37293 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM286545675 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM286545675 | ||
| 003 | DE-627 | ||
| 005 | 20231225051953.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2018 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.5811/westjem.2018.5.37293 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0955.xml |
| 035 | |a (DE-627)NLM286545675 | ||
| 035 | |a (NLM)30013697 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Michelson, Edward A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Emergency Department Time Course for Mild Traumatic Brain Injury Workup |
| 264 | 1 | |c 2018 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.09.2018 | ||
| 500 | |a Date Revised 18.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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 well known. National emergency medicine organizations have recommended reducing unnecessary testing, including head computed tomography (CT) for these patients.10 | ||
| 520 | |a METHODS: 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 each step was estimated by a panel of United States emergency physicians and nurses. We subsequently validated 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 evaluated for mTBI | ||
| 520 | |a RESULTS: Evaluation for mTBI was estimated at 401 minutes (6.6 hours) in EDs. Time related to head CT comprised about one-half of the total LOS. Real-time data from two sites corroborated the estimate of median time difference between ED admission and discharge, at 6.3 hours for mTBI | ||
| 520 | |a CONCLUSION: Limiting use of head CT as part of the workup of mTBI to more serious cases may reduce time spent in the ED and potentially improve overall ED throughput | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Huff, J Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Loparo, Mae |e verfasserin |4 aut | |
| 700 | 1 | |a Naunheim, Rosanne S |e verfasserin |4 aut | |
| 700 | 1 | |a Perron, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Rahm, Martha |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, David W |e verfasserin |4 aut | |
| 700 | 1 | |a Stone, Joseph A |e verfasserin |4 aut | |
| 700 | 1 | |a Berger, Ariel |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The western journal of emergency medicine |d 2007 |g 19(2018), 4 vom: 16. Juli, Seite 635-640 |w (DE-627)NLM189618582 |x 1936-9018 |7 nnns |
| 773 | 1 | 8 | |g volume:19 |g year:2018 |g number:4 |g day:16 |g month:07 |g pages:635-640 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.5811/westjem.2018.5.37293 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 19 |j 2018 |e 4 |b 16 |c 07 |h 635-640 | ||