{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T22:48:12Z","timestamp":1762642092644},"reference-count":19,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2018,5,14]]},"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Emergency departments (EDs) are usually the first point of contact, and often the only medical service available, for patients with mild traumatic brain injury (mTBI) in rural and regional areas. Clinical practice guidelines (CPGs) have been created to ensure best practice management of mTBI in EDs. Adherence to mTBI CPGs has rarely been evaluated in rural and regional areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this paper was to assess a regional health service\u2019s adherence to their mTBI CPG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was\u00a0a 12-month retrospective audit of 1280 ED records of patients\u00a0\u226516 years presenting with mTBI to a regional Australian ED. Case selection used the Victorian Admitted Episodes Dataset codes for suspected head injury: principal diagnosis codes (S00-T98), concussive injury recorded in diagnosis codes (S06.00-S06.05) and unintentional external cause code (V00-X59). The\u00a0data were collected to determine 4-hour observation rates, CT scan rates, safe discharge and appropriate referral documentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fewer people received a CT scan than qualified (n=245, 65.3%), only 45% had 4-hour observations recorded, safe discharge was documented in 74.1% of cases and 33% received educational resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion\/conclusion<\/jats:title><jats:p>Several key elements for the management of mTBI were under-recorded, particularly 4-hour observations, safe discharge and education. Acquired brain injury\u00a0clinic referrals were received in overwhelmingly fewer cases than\u00a0had\u00a0a CT scan (n=19, 6.3%). Overall, this study suggests that the regional health service does not currently fully adhere to the CPG and that\u00a0the referral services are potentially underutilised.<\/jats:p><\/jats:sec>","DOI":"10.1136\/injuryprev-2018-042865","type":"journal-article","created":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T14:07:37Z","timestamp":1528121257000},"page":"390-394","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Evaluating mild traumatic brain injury management at a regional emergency department"],"prefix":"10.1136","volume":"24","author":[{"given":"Ashlee Maree","family":"Brown","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dara M","family":"Twomey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Wong Shee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,4]]},"reference":[{"key":"2024053003144945000_24.5.390.1","doi-asserted-by":"crossref","unstructured":"Langlois JA , Rutland-Brown W , Thomas KE . 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Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2006.","DOI":"10.1037\/e721222007-001"},{"key":"2024053003144945000_24.5.390.2","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-199309000-00010"},{"key":"2024053003144945000_24.5.390.3","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.ajem.2014.04.003","article-title":"ED disposition of the Glasgow Coma Scale 13 to 15 traumatic brain injury patient: analysis of the transforming research and clinical knowledge in TBI study","volume":"32","author":"Ratcliff","year":"2014","journal-title":"Am J Emerg Med"},{"key":"2024053003144945000_24.5.390.4","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/1745-6215-15-281","article-title":"Implementing evidence-based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: study protocol for a cluster randomised controlled trial","volume":"15","author":"Bosch","year":"2014","journal-title":"Trials"},{"key":"2024053003144945000_24.5.390.5","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jen.2009.07.001","article-title":"Mild traumatic brain injury\/concussion: a review for ED nurses","volume":"36","author":"Bergman","year":"2010","journal-title":"J Emerg Nurs"},{"key":"2024053003144945000_24.5.390.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2008.08.017"},{"key":"2024053003144945000_24.5.390.7","doi-asserted-by":"publisher","DOI":"10.5694\/mja12.11217"},{"key":"2024053003144945000_24.5.390.8","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jen.2011.04.006","article-title":"Mild traumatic brain injury: are ED providers identifying which patients are at risk?","volume":"38","author":"Stuart","year":"2012","journal-title":"J Emerg Nurs"},{"key":"2024053003144945000_24.5.390.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092720"},{"key":"2024053003144945000_24.5.390.10","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/TME.0b013e318217c958","article-title":"Mild traumatic brain injury: a Midwest survey of discharge teaching practices of emergency department nurses","volume":"33","author":"Bay","year":"2011","journal-title":"Adv Emerg Nurs J"},{"key":"2024053003144945000_24.5.390.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2011.03.021"},{"key":"2024053003144945000_24.5.390.12","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-9-1"},{"key":"2024053003144945000_24.5.390.13","unstructured":"Ashby K , Stathakis VZ , Day L . 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