- Title
- Early Management of Isolated Severe Traumatic Brain Injury Patients in a Hospital Without Neurosurgical Capabilities: a Consensus and Clinical Recommendations of the World Society of Emergency Surgery (WSES)
- Creator
- Picetti, Edoardo; Catena, Fausto; Buki, Andras; Cerasti, Davide; Chesnut, Randall M.; Citerio, Giuseppe; Coccolini, Federico; Coimbra, Raul; Coniglio, Carlo; Fainardi, Enrico; Gupta, Deepak; Gurney, Jennifer M.; Abu-Zidan, Fikri; Hawrylux, Gregory W. J.; Helbok, R; Hutchinson, PJA; Iaccarino, C; Kolias, A; Maier, RW; Martin, MJ; Meyfroidt, G; Okonkwo, DO; Rasulo, F; Ansaloni, Luca; Rizoli, S; Rubiano, A; Sahuquillo, J; Sams, VG; Servadei, F; Sharma, D; Shutter, L; Stahel, PF; Taccone, FS; Udy, A; Armonda, Rocco A.; Zoerle, T; Agnoletti, V; Bravi, F; De Simone, B; Kluger, Y; Martino, C; Moore, EE; Sartelli, M; Weber, D; Robba, C; Bala, Miklosh; Balogh, Zsolt J.; Bertuccio, Alessandro; Biffl, Walt L.; Bouzat, Pierre
- Relation
- World Journal of Emergency Surgery Vol. 18, Issue 1, no. 5
- Publisher Link
- http://dx.doi.org/10.1186/s13017-022-00468-2
- Publisher
- BioMed Central (BMC)
- Resource Type
- journal article
- Date
- 2023
- Description
- Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.
- Subject
- traumatic brain injury; management; transfer; hub; spoke
- Identifier
- http://hdl.handle.net/1959.13/1480380
- Identifier
- uon:50490
- Identifier
- ISSN:1749-7922
- Rights
- x
- Language
- eng
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