{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:21:11Z","timestamp":1787829671730,"version":"build-2784847793"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To describe management, imaging pathways and systems challenges for adult closed head injury presentations to a rural Queensland emergency department without hospital\u2010based CT.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort study was conducted at Dalby Hospital from January 2022 to January 2023. Adult patients presenting with closed head injury were identified through manual Emergency Department Information System review. Demographic, clinical, imaging, disposition and documentation variables were extracted from medical records. CT access was categorised as local offsite private radiology or interhospital transfer.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 118 patients were included; 73\/118 (61.9%) were male and mean age was 48.6\u2009years. CT head was performed in 60\/118 (50.8%) patients. Of these, 30\/60 (50.0%) underwent CT through an offsite private radiology provider and 30\/60 (50.0%) required interhospital transfer. Intracranial haemorrhage was identified in 9\/60 (15.0%) imaged patients, comprising 7 subdural and 2 subarachnoid haemorrhages. Documentation of observation and discharge advice was variable. A planned period of observation was documented in 55\/118 (46.6%) cases. Among patients discharged from the emergency department or short\u2010stay unit, written patient information was documented in 36\/72 (50.0%), red\u2010flag discussion in 32\/72 (44.4%), and no\u2010driving advice in 5\/72 (6.9%).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Patients with closed head injury in this rural emergency department had substantial neuroimaging needs despite the absence of hospital\u2010based CT. Imaging was obtained through either local offsite private radiology or interhospital transfer, requiring clinicians to consider both imaging need and pathway safety. Variable documentation of observation and discharge advice highlights an opportunity to strengthen safety\u2010netting in rural head injury care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1742-6723.70307","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:23:41Z","timestamp":1784161421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Adult Closed Head Injury in Rural Queensland Without Hospital\u2010Based\n CT<\/scp>\n : A Retrospective Cohort Study"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6175-4152","authenticated-orcid":false,"given":"Thomas","family":"Maouris","sequence":"first","affiliation":[{"name":"Dalby Hospital, Darling Downs Health Dalby Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lachlan","family":"Clarke","sequence":"additional","affiliation":[{"name":"Toowoomba Base Hospital Toowoomba Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmyn","family":"Dew","sequence":"additional","affiliation":[{"name":"Griffith University Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Head Injuries in Australia 2020\u201321","author":"Australian Institute of Health and Welfare","year":"2023"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.08.021"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200007133430204"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04561-X"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2015.07.050"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-017-3071-1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002313"},{"key":"e_1_2_11_9_1","volume-title":"Closed Head Injury (Adult) Clinical Pathway [Internet]","author":"Queensland Health"},{"key":"e_1_2_11_10_1","article-title":"Rate of Intracranial Hemorrhage After Minor Head Injury","volume":"12","author":"Bonney P. A.","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2023.111181"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajr.12846"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13559"},{"key":"e_1_2_11_14_1","first-page":"195","article-title":"A Retrospective Observational Study Investigating Safety Netting Documentation in the Emergency Department","volume":"22","author":"Wood C. H.","year":"2023","journal-title":"Acute Medicine"},{"key":"e_1_2_11_15_1","volume-title":"Head Injury: Assessment and Early Management (NG232)","author":"National Institute for Health and Care Excellence","year":"2023"},{"key":"e_1_2_11_16_1","article-title":"Challenges and Opportunities in Diagnosing and Managing Mild Traumatic Brain Injury in Rural Settings","volume":"22","author":"Daugherty J.","year":"2022","journal-title":"Rural and Remote Health"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70307","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1742-6723.70307","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70307","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:48:11Z","timestamp":1787827691000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70307"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/1742-6723.70307"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70307","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]},"assertion":[{"value":"2026-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70307"}}