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UK groups research transport for head injuries

Opinion has been divided on issue of trauma, including serious head injuries, and benefits of traveling longer distances to specialist hospital

The Northern Echo

UNITED KINGDOM — A pioneering research trial has been launched in the North-East to investigate whether serious head injury patients should be taken to the nearest hospital or a specialist neurological centre.

Opinion has been divided on the issue of trauma, including serious head injuries, and the benefits of travelling longer distances to a specialist hospital.

The National Institute for Health and Clinical Excellence (NICE) stated that evidence for bypassing the nearest hospital in favour of a specialist centre was inconclusive, so the issue was in need of further study.

The North East Ambulance Service (NEAS) has teamed up with counterparts in the NorthWest to launch HITS-NS, the Head Injury Transportation Straight to Neurosurgery Study, with funding from the Department of Health, through the Health Technologies Assessment Programme.

A ground-breaking initiative, the research involves three specialist neurosurgical centres and 11 general hospitals. In the NorthEast eight general hospitals and two neurosurgical centres — based at the James Cook University Teaching Hospital in Middlesbrough and the Royal Victoria Infirmary in Newcastle - are taking part in the trial. More than 900 NEAS staff, based at 46 ambulance stations in the NorthEast, will also be involved.

During the trial, two approaches will be followed at random by NEAS paramedics.

Patients will either be taken to the nearest hospital A&E department or transported directly to a specialist neurosurgical centre. The patients who go to the nearest A&E will be expected to transfer to specialist neurosurgical care after being stabilised.

NEAS medical director, Kyee Han, said: “It’s important to stress that patients in each arm of the trial will continue to receive the very best available care from themoment of injury.

“The aim of this trial is to look at the journey the patient takes to get to neurosurgical care as it is widely accepted that patients with severe traumatic brain injury should bemanaged in neurosurgical centres.”

Graham McClelland, the NEAS paramedic overseeing the project, added: “During this initial feasibility study the research team will evaluate how well ambulance service crews are able to comply with the study protocol before a larger full-scale trial is designed.”

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