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TS06
NEUROTRAUMA IN THE RURAL AND REMOTE SETTING
Author(s) -
Vonau M.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04133_6.x
Subject(s) - medicine , head injury , medical emergency , population , neurosurgery , rural area , craniotomy , emergency medicine , surgery , environmental health , pathology
This paper reviews the management of head injuries arising in the rural and remote areas of Queensland. Methodology Data was obtained from the Queensland Trauma Registry from January 2003 to December 2004, a total of 3,088 patients, 1667 classified as major injury. Queensland is the second largest state in Australia with most of the 4 million population living along the eastern seaboard, mainly in the southeast corner and a widely dispersed rural population in small towns. There are neurosurgical services in Brisbane, the Gold Coast and Townsville. Results Forty percent of patients are referred from another hospital for definitive care with transfer times of up to 10 hours between the referring and definitive care hospital. Of those requiring craniotomy 60% of patients are referred from a another hospital again with lengthy transfer times well beyond the 2 hour transfer time for the deteriorating head injury with intracranial haemorrhage as recommended in the NSA/RACS set of guidelines for the “Management of Acute Neurotrauma in Rural and Remote Locations”. This paper reviews the problems which include deficient retrieval resources, a reluctance by non‐neurosurgeons to perform emergency neurosurgery, a lack of training amongst younger surgeons, and perceived medicolegal issues. The paper also compares the situation in other states and territories. Conclusions Recommendations are made to improve the delivery of neurotrama care.