The role of computerized tomography in the care of the injured

The records of 377 patients with head injuries admitted to the South East Thames Regional Neurosurgical Unit in the two years following the introduction of the EMI scanner (computerized tomography) were examined. Each patient was assessed on the reason for transfer, the necessity for transfer, the safety of transfer and whether immediate access to a scanner would have altered management. The results show that the majority of patients were referred because of a possible intracranial haematoma. Thirty per cent of the patients required operation, in 6 per cent transfer was unnecessary and 10 per cent arrived with inadequate resuscitation. It is suggested that with a wider deployment of head-dedicated scanners to some accident centres, the number of patients with head injuries at present being transferred to special units for assessment would be reduced substantially, with improvement of patient care.