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Patients were referred to the Royal Adelaide Hospital (RAH), a level 1 trauma centre with a major neurosurgical service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>From 2000 to 2013, 1107 multiple trauma cases included 162 with severe <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">Local medical officers (LMOs)<\/jats:styled-content> phoned a specific number to access resuscitative and neurosurgical advice. Onsite neurosurgical support was provided when requested. Specialist teams later retrieved these patients to <jats:styled-content style=\"fixed-case\">RAH<\/jats:styled-content>. Locations were coded according to the Accessibility\/Remoteness Index of Australia (ARIA+). Injuries were coded using <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content> 9 and 10.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>General surgeon <jats:styled-content style=\"fixed-case\">LMOs<\/jats:styled-content> drained nine clinically progressive <jats:styled-content style=\"fixed-case\">ICHs<\/jats:styled-content>. Neurosurgical attendance was provided in four instances. Eight patients survived. The remaining 153 patients had other injuries involving thoraco\u2010abdominal organs, spine, pelvis and limbs. The overall mortality was 30%. Twenty\u2010six had <jats:styled-content style=\"fixed-case\">ICHs<\/jats:styled-content> requiring surgical drainage later at the <jats:styled-content style=\"fixed-case\">RAH<\/jats:styled-content>, with 46% mortality. Average <jats:styled-content style=\"fixed-case\">Injury Severity Score<\/jats:styled-content> was 30 (range 9\u201366). Male\/female ratio was 76\/24. Motor vehicular accidents predominated (60%), followed by falls (26%) and assaults (10%). Those under 30 years were overrepresented. Patients were transported a mean distance of 283\u2009km (maximum distance 2600\u2009km).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>\n<jats:styled-content style=\"fixed-case\">LMOs<\/jats:styled-content> in remote locations may consider immediate drainage of deteriorating traumatic <jats:styled-content style=\"fixed-case\">ICH<\/jats:styled-content>. Adequate support from a distant major trauma centre can help achieve acceptable outcomes. Effective communications are vital. <jats:styled-content style=\"fixed-case\">The Royal Australasian College of Surgeons<\/jats:styled-content> and Neurosurgical Society of Australasia guidelines based on <jats:styled-content style=\"fixed-case\">the Early Management of Severe Trauma<\/jats:styled-content> protocols can assist <jats:styled-content style=\"fixed-case\">LMOs<\/jats:styled-content> in making the decision to undertake emergency craniotomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13583","type":"journal-article","created":{"date-parts":[[2016,5,4]],"date-time":"2016-05-04T16:08:51Z","timestamp":1462378131000},"page":"80-85","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Management of acute traumatic intracranial haematoma in rural and remote areas of Australia"],"prefix":"10.1111","volume":"87","author":[{"given":"John","family":"Gilligan","sequence":"first","affiliation":[{"name":"Health Advisory Committee, Royal Flying Doctor Service Central Operations, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Reilly","sequence":"additional","affiliation":[{"name":"School of Medical Sciences University of Adelaide  Adelaide, South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Pearce","sequence":"additional","affiliation":[{"name":"ED\/Trauma Royal Adelaide Hospital  Adelaide, South Australia Australia"},{"name":"MedSTAR SA Ambulance Service  Adelaide, South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Taylor","sequence":"additional","affiliation":[{"name":"Australian Population and Migration Research Centre University of Adelaide  Adelaide, South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0967-5868(99)90619-7"},{"key":"e_1_2_6_3_1","unstructured":"CareFlight. 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