The Need for Head Protection Protocols for Craniectomy Patients during Rest, Transfers and Turning

Area of Science:

• Neurosurgery
• Patient Safety
• Medical Device Development

Background:

• Patients post-craniectomy require head protection during mobilization to prevent brain injury.
• Existing guidelines inadequately address head protection needs during rest, transfers, or turning.

Purpose of the Study:

• To highlight the critical need for head protection protocols for post-craniectomy patients during rest and transfers.
• To investigate the frequency of craniectomy site exposure and current protective measures.
• To propose a practical protocol for head protection in this patient population.

Main Methods:

• Comprehensive literature search of MEDLINE and EMBASE for relevant studies.
• Survey and interviews with neurosurgical staff and patients regarding craniectomy site contact and precautions.
• Analysis of patient-reported symptoms and staff practices during rest, transfer, and turning.

Main Results:

• No existing literature was found on head protection during rest, transfer, or turning post-craniectomy.
• A significant percentage of patients (59%) and staff (67%) reported craniectomy site contact during rest, often daily.
• Many staff (44%) used no preventative methods, and few (35%) used additional precautions during transfers; most patients (63%) received no discharge information.
• Some patients reported symptoms suggestive of raised intracranial pressure due to site contact.

Conclusions:

• There is a clear deficit in established protocols for head protection in post-craniectomy patients during rest and transfers.
• Patient and staff experiences underscore the high frequency of potentially harmful craniectomy site exposure.
• Development and implementation of pragmatic head protection guidelines are urgently needed to improve patient safety and outcomes.