Emergency department management of head injuries

Head injuries are a frequent and important problem from the view of the emergency department physician as well as from the national public health perspective. Of the two million head injuries each year, many are so mild that the individual does not present to a physician. However, approximately 20 per cent are of sufficient magnitude to warrant hospitalization; these amount to more than 1000 head injury admissions each day across the country. The role of the emergency department is to guarantee that patients are triaged according to severity and that proper diagnosis and initial management are carried out expeditiously. The ultimate outcome in these patients depends, in large part, on how vigorously the emergency department fulfills this role. It is hoped that the triage system and early management protocols presented in this article will aid these goals.