National Neurosurgical Admissions Policy

T/F TBI patients to neurosurgeons

Criteria for transfer of patients with Traumatic Brain Injury (TBI) to the National Neurosurgical Centre (NNC) at Beaumont Hospital:

All patients with TBI and an abnormal CT scan must be discussed with Neurosurgery.

The following patients will be accepted for transfer to Beaumont hospital NNC:

1. All patients with GCS 3-8
2. Exceptions: The following situations require case by case discussion between referrer and neurosurgeon and may not be appropriate for transfer:
   1. Completely normal CT scan and high alcohol or drug levels on toxicology who qualify for wake & assess
   2. Bilaterally dilated and unreactive pupils where any intervention is deemed futile
   3. Age > 75 years – the prognosis in this age group with severe TBI (GCS 3-8) is extremely poor and decisions will be made on a case by case basis
3. All patients with GCS 9-12 except those with a completely normal CT scan
4. Patients with GCS 13-15 with:
   1. EDH > 5 mm in thickness
   2. SDH > 5 mm in thickness
   3. Contusion > 4 cm (30 cc); midline shift > 5 mm
   4. Open skull fracture with torn dura / exposed brain
   5. Other patients on a case by case basis

Print version T/F criteria.

CUH

It has been agreed (letter) that the following patients should be admitted under the care of the Neurosurgical team rather than the emergency Medicine team.

• Any patient with an acute subdural or extradural haematoma on CT
• Patients with compound or depressed skull fractures (including those that do not require immedate surgery)
• Patients requiring ventilation because of their head injury

Agreement letter.