October 3, 2023

The guidelines also address the crucial first steps in the management of head injuries, which often occur outside of the hospital setting. Public health literature and non-medical sources of advice, such as St John Ambulance and police officers, are encouraged to advise individuals with any concerns after a head injury, regardless of the injury severity, to seek immediate medical advice.Remote advice services, such as NHS 111, play a critical role in the initial assessment and referral of individuals who have sustained a head injury. These services are advised to refer individuals to the emergency ambulance services for emergency transport to the emergency department if there are any risk factors present, such as unconsciousness or lack of full consciousness, any focal neurological deficit since the injury, any suspicion of a complex skull fracture or penetrating head injury, any seizure since the injury, a high-energy head injury, or if there is no other way of safely transporting the person to the hospital emergency department.Furthermore, remote advice services should refer individuals who have sustained a head injury to a hospital emergency department if there are any of these risk factors: any loss of consciousness because of the injury, from which the person has now recovered, amnesia for events before or after the injury, a persistent headache since the injury, any vomiting episodes since the injury, any previous brain surgery, any history of bleeding or clotting disorders, current anticoagulant and antiplatelet (except aspirin monotherapy) treatment, current drug or alcohol intoxication, any safeguarding concerns (for example, possible non-accidental injury or a vulnerable person is affected), irritability or altered behaviour, particularly in babies and children under 5, and continuing concern by helpline staff about the diagnosis.These guidelines highlight the importance of early assessment and referral in the management of head injuries, and the crucial role of non-medical personnel and remote advice services in this process. They ensure that individuals with head injuries receive prompt and appropriate care, thereby improving outcomes and reducing the risk of complications.

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