Handling of nonsevere head injuries

In emergency patients with nonsevere head injuries, there are conflicting opinions over which patients should be admitted for observation, but little data directly useful to the emergency physician in making this decision. The literature was reviewed and records of 182 patients presenting for head injury were examined. Although many factors must be considered, by far the most helpful element in predicting outcome is the mental status of the patient as observed in the emergency department. Features suggesting depressed skull fracture or possible foreign bodies require radiographic examination. Most patients can be observed in the emergency department mainly for changes in level of consciousness and discharged with instructions for further observation at home.