Related Experiment Video
Updated: Jul 20, 2025
SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
First steps toward a BIG change: A pilot study to implement the Brain Injury Guidelines across a 24-hospital system
Annika Bickford Kay1, Samantha A Malone1, Joseph R Bledsoe2
1Division of Trauma Services and Surgical Critical Care, Intermountain Medical Center, Murray, UT, USA.
Introduction:
The modified Brain Injury Guidelines (mBIG) support a subset of low-risk patients to be managed without repeat head computed tomography (RHCT), neurosurgical consult (NSC), or hospital transfer/admission. This pilot aimed to assess mBIG implementation at a single facility to inform future systemwide implementation.
Methods:
Single cohort pilot trial at a level I trauma center, December 2021-August 2022. Adult patients included if tICH meeting BIG 1 or 2 criteria. BIG 3 patients excluded.
Results:
No patients required neurosurgical intervention. 72 RHCT and 83 NSC were prevented. 21 isolated BIG 1 were safely discharged home from the ED. No hospital readmissions for tICH. Protocol adherence rate was 92%.
Conclusion:
Implementation of the mBIG at a single trauma center is feasible and optimizes resource utilization. This pilot study will inform an implementation trial of the mBIG across a 24-hospital integrated health system.
