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Mild Head Injury Home Management

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1. Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning in Children With Mild Traumatic Brain Injury?

and low positive predictive value, thus somewhat limiting its ability to reduce the number of CT scans and hospital costs. x 8 Ruan, S., Noyes, K., and Bazarian, J.J. The economic impact of S-100B as a pre-head CT screening test on emergency department management of adult patients with mild traumatic brain injury. J Neurotrauma . 2009 ; 26 : 1655–1664 In addition, many facilities may not have immediate access to the results of the test, with personal experience showing a turnaround time of 3 to 18 (...) Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning in Children With Mild Traumatic Brain Injury? Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning in Children With Mild Traumatic Brain Injury? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 73, Issue 5, Pages 456–458 Can S100B Serum Biomarker Testing Reduce Head Computed Tomography Scanning

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2019 Annals of Emergency Medicine Systematic Review Snapshots

2. Mild Head Injury Home Management

Mild Head Injury Home Management Mild Head Injury Home Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Mild Head Injury (...) Home Management Mild Head Injury Home Management Aka: Mild Head Injury Home Management , Mild Head Injury Discharge Instructions , Head Injury Precautions From Related Chapters II. Management Follow-up One week follow-up clinic (or immediately if warning signs occur as below) Consider clinic (sports medicine) ral precautions Avoid and sedating medications for 3 days Remain with a reliable companion for 24 hours Avoid driving for at least the first 24 hours (and until most significant symptoms have

2018 FP Notebook

3. Management of Concussion-mild Traumatic Brain Injury (mTBI)

• Neurological deficit: motor or sensory • Double vision • Worsening headache • Cannot recognize people or disoriented to place • Slurred speech • Unusual behaviorVA/DoD Clinical Practice Guideline for the Management of Concussion-mild Traumatic Brain Injury February 2016 Page 23 of 133 Evaluating individuals in military operational settings who are exposed to potentially concussive events (e.g., blast, motor vehicle accidents, blow to the head) while in theater is strongly encouraged as soon as possible (...) Management of Concussion-mild Traumatic Brain Injury (mTBI) VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF CONCUSSION-MILD TRAUMATIC BRAIN INJURY Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision making. They are not intended to define a standard

2016 VA/DoD Clinical Practice Guidelines

4. Trauma Bay Disposition of Infants and Young Children With Mild Traumatic Brain Injury and Positive Head Imaging. (PubMed)

Trauma Bay Disposition of Infants and Young Children With Mild Traumatic Brain Injury and Positive Head Imaging. To describe the disposition of infants and young children with isolated mild traumatic brain injury and neuroimaging findings evaluated at a level 1 pediatric trauma center, and identify factors associated with their need for ICU admission.Retrospective cohort.Single center.Children less than or equal to 4 years old with mild traumatic brain injury (Glasgow Coma Scale 13-15 (...) included ICU (48%), ward (38%), intermediate care unit and home (7% each). Overall, 1% required intubation, 4.3% seizure management, and 4.3% neurosurgical procedures; 15% were diagnosed with nonaccidental trauma. None of the ward/intermediate care unit patients were transferred to ICU. Median ICU/hospital length of stay was 2 days. Most patients (99%) were discharged home without neurologic deficits. The ICU subgroup included all patients with midline shift, 62% patients with intracranial hemorrhage

2019 Pediatric Critical Care Medicine

5. Management of Mild Head Injury

Management of Mild Head Injury Management of Mild Head Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Management of Mild Head (...) Injury Management of Mild Head Injury Aka: Management of Mild Head Injury , Mild Traumatic Brain Injury , MTBI , Minor Head Injury , Mild Head Injury , Mild Head Trauma From Related Chapters II. Epidemiology Mild Traumatic Brain Injury (MTBI) accounts for 75% of the 1.7 Million people in U.S. who suffer TBI annually III. Criteria : 13-15 (at two hours) Loss of consciousness may have occurred with injury Awake and oriented with normal ination IV. History See Time and mechanism of injury Loss

2018 FP Notebook

6. Evaluation of a targeted, theory-informed implementation intervention designed to increase uptake of emergency management recommendations regarding adult patients with mild traumatic brain injury: results of the NET cluster randomised trial. (PubMed)

intervention (Neurotrauma Evidence Translation (NET) intervention) was designed to increase the uptake of three clinical practice recommendations regarding the management of patients who present to Australian EDs with mild head injuries. The intervention involved local stakeholder meetings, identification and training of nursing and medical local opinion leaders, train-the-trainer workshops and standardised education materials and interactive workshops delivered by the opinion leaders to others within (...) Evaluation of a targeted, theory-informed implementation intervention designed to increase uptake of emergency management recommendations regarding adult patients with mild traumatic brain injury: results of the NET cluster randomised trial. Evidence-based guidelines for management of mild traumatic brain injury (mTBI) in the emergency department (ED) are now widely available; however, clinical practice remains inconsistent with these guidelines. A targeted, theory-informed implementation

2019 Implementation Science Controlled trial quality: predicted high

7. rTMS Treatment of Persistent Headache and Post Concussion Symptoms Attributed to Mild Traumatic Injury to the Head

rTMS Treatment of Persistent Headache and Post Concussion Symptoms Attributed to Mild Traumatic Injury to the Head rTMS Treatment of Persistent Headache and Post Concussion Symptoms Attributed to Mild Traumatic Injury to the Head - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. rTMS Treatment of Persistent Headache and Post Concussion Symptoms Attributed to Mild Traumatic Injury to the Head (TOPiCS-rTMS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03691272 Recruitment Status : Active

2018 Clinical Trials

8. Head Injury and patients on Anticoagulation/Antiplatelet Therapies

. Barbosa RR et al. 2012. Evaluation and management of mild traumatic brain injury: An Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg, 73;5:Sup 4. 7. Vos PE, et al. 2012. Mild traumatic brain injury. European journal of neurology 19(2): 191-198. 8. NSW Ministry of Health. 2011. Adult trauma clinical practice guidelines: Initial management of closed head injury in adults. (2nd Ed). Accessed March 2017. http://www.aci.health.nsw.gov.au/__data/assets (...) and frequency of CT brain scans in the period following the minor head trauma (eg fall) to ensure that intracranial bleeding has not occurred? 6 Guideline Level 2 evidence Clinicians should perform brain CT scan on patients that present with suspected brain injury in the acute setting if it is available. 7 Guideline Recommendations for: Clinical decision rules for CT, Initial Patient Management, Home discharge, Clinical Observation, Follow up (Anticoagulation therapy = risk factor) 8 Guideline Indications

2017 Monash Health Evidence Reviews

9. Sirens to Scrubs: Minor Head Injury

-hospital management of isolated minor head injury Introduce the Canadian CT Head Rule as a guide for decision-making in minor head injury Discuss return-to-activity guidelines for patients with concussions What pre-hospital treatments may be considered for Judy? Spinal motion restriction Although spinal cord injury is always considered in patients who have fallen and/or struck their head, Judy is an otherwise healthy patient who suffered a simple mechanical fall from standing and has no obvious (...) that she is at low risk for significant brain injury, and a CT scan would not be beneficial for Judy. She is diagnosed with a mild traumatic brain injury, or a concussion, and discharged home. What advice will the physician give Judy about post-concussion recovery? Regardless of the patient’s daily vocation, they should be advised to avoid participating in any activities that put them at risk for another concussion while recovering, especially in the first 7 to 10d after injury. Return-to-work

2018 CandiEM

10. Shaken baby syndrome or non-accidental head injury caused by shaking

and paraclinical assessment necessary and sufficient to detect them 9 1.3 Differential diagnoses for NAHI caused by shaking 14 1.4 Action to be taken, depending on the clinical situation 14 2. Causal mechanism of the lesions 16 2.1 Shaking without impact 16 2.2 Shaking by a child 17 2.3 Mild head injury caused by a fall from a low height ( 10 RH but 50% of the retina Depth = depends on the layer of the retina reached: ? i = intraretinal haemorrhages (excluding the region under the internal limiting membrane (...) . The following mechanisms and circumstances were examined: ? shaking without impact; ? mild head injury caused by a fall from a low height; ? play; ? childbirth; ? hypoxia or anoxia; ? resuscitation manoeuvres. The update looked at other mechanisms mentioned: vaccinations, dehydration, thrombosis of the intracranial venous sinuses and haemostasis disorders. 2.1 Shaking without impact Shaking is a highly violent action during which the cervical spine suffers brutal whiplash. Subdural bleeding and RH

2017 HAS Guidelines

11. Management of Rotator Cuff Injuries

Management of Rotator Cuff Injuries View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 1 MANAGEMENT OF ROTATOR CUFF INJURIES CLINICAL PRACTICE GUIDELINE Adopted by the American Academy of Orthopaedic Surgeons Board of Directors March 11, 2019 Endorsed by: Please cite this guideline as: American Academy of Orthopaedic Surgeons. Management of Rotator Cuff Injuries Clinical Practice Guideline. https://www.aaos.org/rotatorcuffinjuriescpg Published (...) March 11, 2019 View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 2 Disclaimer This Clinical Practice Guideline was developed by an AAOS physician volunteer Clinical Practice Guideline development group based on a systematic review of the current scientific and clinical information and accepted approaches to management of rotator cuff injuries. This clinical practice guideline is not intended to be a fixed protocol, as some patients may require more

2019 American Academy of Orthopaedic Surgeons

12. Management of paediatric minor head injuries. Safe discharge?

In patients with minor head injuries and no known bleeding risks, who are GCS 15 on arrival, have no focal neurological deficit on examination and who have had an normal CT scan, hospital admission is unnecessary if a capable parent is willing to take the child home. References Dias MS, Lillis KA, Calvo C et al. Management of accidental minor head injuries in children: a prospective outcomes study. Journal of Neurosurgery 2004;101(1):38-43. Mitchell KA, Fallat ME, Raque GH et al. Evaluation of minor head (...) neurologic examination in the emergency department. Pediatric Emergency Care 1996;12(3):160-5. Roddy SP, Cohn SM, Moller BA et al. Minimal head trauma in children revisited: is routine hospitalisation required?. Pediatrics 1998;101(4 Pt 1):575-7. Mandera M, Wencel T, Bazowski P et al. How should we manage children after mild head injury?. Childs Nerv System 2000;16(3):156-60. Adams J, Frumiento C, Shatney-Leach L et al. Mandatory admission after isolated mild closed head injury in children

2013 BestBETS

13. Broad Validation Study of a Management Algorithm Mild Head Injury in Children

Broad Validation Study of a Management Algorithm Mild Head Injury in Children Broad Validation Study of a Management Algorithm Mild Head Injury in Children - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more (...) . Broad Validation Study of a Management Algorithm Mild Head Injury in Children (EVEACE) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02357186 Recruitment Status : Completed First Posted : February 6, 2015 Last Update Posted : December 12, 2018 Sponsor: Nantes University Hospital Information

2015 Clinical Trials

14. Clinical Practice Guideline for the Management of Communication and Swallowing Disorders following Paediatric Traumatic Brain Injury

following Paediatric Traumatic Brain Injury 20 1.3 Clinical need for this guideline Whilst TBI can have a considerable and often long-term impact on a child’s communication and swallowing, recent evidence suggests that formalised evidence-based guidelines or protocols to manage speech and swallowing disorders are not being utilised within key Australian head injury centres. 18 The absence of evidence-based guidelines to inform referral, assessment and treatment for TBI patients is likely a reflection (...) Clinical Practice Guideline for the Management of Communication and Swallowing Disorders following Paediatric Traumatic Brain Injury CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF COMMUNICATION AND SWALLOWING DISORDERS FOLLOWING PAEDIATRIC TRAUMATIC BRAIN INJURY GUIDELINE© Murdoch Childrens Research Institute and the National Health and Medical Research Council Centre of Research Excellence on Psychosocial Rehabilitation in Traumatic Brain Injury 2017 Publisher: Murdoch Childrens Research

2017 Clinical Practice Guidelines Portal

15. Mild Head Injury Home Management

Mild Head Injury Home Management Mild Head Injury Home Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Mild Head Injury (...) Home Management Mild Head Injury Home Management Aka: Mild Head Injury Home Management , Mild Head Injury Discharge Instructions , Head Injury Precautions From Related Chapters II. Management Follow-up One week follow-up clinic (or immediately if warning signs occur as below) Consider clinic (sports medicine) ral precautions Avoid and sedating medications for 3 days Remain with a reliable companion for 24 hours Avoid driving for at least the first 24 hours (and until most significant symptoms have

2015 FP Notebook

16. Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition

Home Health Th under Bay, Ontario21 BEST PRACTICE GUIDELINES • www.RNAO.ca BACKGROUND Assessment and Management of Pressure Injuries for the Interprofessional Team, Th ird Edition Leah Jaakkimainen, RN, BScN Registered Nurse Queensway Carleton Hospital Ottawa, Ontario Betsy John, BA, MN, RN(EC), NP-Adult, IIWCC Skin & Wound Care, Nurse Practitioner St. Joseph’s Healthcare Hamilton Hamilton, Ontario Debra Johnston, MN, RN, CETN(C) CNS, Enterostomal Th erapy Nurse University Health Network Toronto (...) Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition Clinical Best Practice Guidelines MAY 2016 Assessment and Management of Pressure Injuries for the Interprofessional T eam Third EditionDisclaimer Th ese guidelines are not binding on nurses, other health care professionals, or the organizations that employ them. Th e use of these guidelines should be fl exible, and based on individual needs and local circumstances. Th ey neither constitute a liability

2016 Registered Nurses' Association of Ontario

17. Trends in Cohabitation Status, Academic Achievement and Socio-economic Indicators After Mild Traumatic Brain Injury

Trends in Cohabitation Status, Academic Achievement and Socio-economic Indicators After Mild Traumatic Brain Injury Trends in Cohabitation Status, Academic Achievement and Socio-economic Indicators After Mild Traumatic Brain Injury - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. Trends in Cohabitation Status, Academic Achievement and Socio-economic Indicators After Mild Traumatic Brain Injury The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03678077 Recruitment Status : Completed First Posted

2018 Clinical Trials

18. Observation is unnecessary following a normal CT brain in warfarinised head injuries: an update

Completed: 30th April 2014 Last Modified: 30th April 2014 Status: Green (complete) Three Part Question In [adult patients on warfarin with a minor head injury] does a [normal CT brain scan] allow [safe discharge home]? Clinical Scenario An elderly woman attends your emergency department (ED) following a mechanical fall. She takes warfarin for atrial fibrillation and has a small occipital haematoma. Her Glasgow Coma Score (GCS) is 15; she has no amnesia and a normal neurological examination but did (...) 68. INR obtained in 57% with average 4.4 and values >3 in 47%, range 1.8–9.5. (There was another group of 49 patients who had GCS 5. Mortality 87.8%) Cohort study Mortality 20 evaluated and sent home from ED. Of these, 35% had CT and all were normal. 18 returned and subsequently diagnosed with significant ICH. 2 patients died at home, 1 with autopsy-confirmed acute SDH. Overall mortality in these 20 patients was 88.8%. 45 patients admitted for observation for head injury± treatment of other

2014 BestBETS

19. Coagulopathy as a risk factor in warfarinised head injury patients

evaluated & sent home from ED. Of these, 35% had CT & all were normal. 18 returned & subsequently diagnosed with significant ICH. 2 patients died at home, 1 with autopsy-confirmed acute SDH. Overall mortality in these 20 patients was 88.8%. 45 patients admitted for observation for head injury +/- treatment of other injuries. CT obtained before admission in 70%, with only 4 showing any ICH. Within 8-18hrs of injury (mean 12hrs), 80% deteriorated to GCS No matched control group. Majority of patients (...) reduce ICH progression and improve mortality. Therefore, both the clinical picture and the INR have not shown to be effective at ruling out ICH in the asymptomatic WHI patient. It is, nevertheless, an important investigation in this setting, as an early check has been shown to allow rapid time to reversal of the INR with ICH. Importantly, Nishijima et al (2013) and Rendell and Batchelor (2013) found that there was no ‘low-risk group’ of warfarinised head injury patients safely managed without CT

2014 BestBETS

20. What Is the Incidence of Intracranial Hemorrhage Among Anticoagulated Patients With Minor Head Trauma?

Jagoda, A.S., Bazarian, J.J., Bruns, J.J. Jr , and American College of Emergency Physicians; Centers for Disease Control and Prevention. Clinical policy: neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting. Ann Emerg Med . 2008 ; 52 : 714–748 To properly weigh the risks and benefits of this approach, it is important to understand the incidence of intracranial hemorrhage among anticoagulated patients with minor head trauma. This study found that the adjusted (...) incidence of intracranial hemorrhage among anticoagulated patients with minor head trauma was 8.9%. Previous studies of patients no longer receiving anticoagulation and with minor head injury have identified rates of intracranial hemorrhage between 4.6% and 6.3%. x 6 Albers, C.E., von Allmen, M., Evangelopoulos, D.S. et al. What is the incidence of intracranial bleeding in patients with mild traumatic brain injury? a retrospective study in 3088 Canadian CT head rule patients. Biomed Res Int . 2013

2019 Annals of Emergency Medicine Systematic Review Snapshots

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