Question:

If you do care for patients who have suffered a blow to the head, do you have specific criteria for when they are to be referred to the ED (e.g., confusion, loss of consciousness, etc.)

Our patients are referred to the ED if our providers feel that there may be the possibility of a bleed based on symptoms and a thorough neurological exam.

Loss of Consciousness
Altered Mental Status
Recurrent Vomiting
Ataxia

loss of consciousness, neuro changes

loss of consciousness, neurological changes, mental status changes

Yes refer to ER for LOC , elderly pt on anticoagulation meds, confusion , lethargy signs of increased icp. Tech cardiac abnormal neuron exam.

AMS, LOC, Neuro deficits

Unstable patient and if have clinical signe of internal sign. Injury

LOC, unsteady gait- we have a CT scanner. We scan PRN- consult with neuro.

No, The urgent care is new and no guidelines are currently in place.

blood thinners, loss of consciousness

There is no protocol in place at the moment, but we have recently developed a committee to create one so that all patients can be evaluated and treated with greater consistency.

no

not really - up to the evaluating clinician

confusion, freq vomiting, altered consciousness, difficulty with extremities-any of the more concerning signs

Symptoms behind headaches. If patient is experiencing nausea/vomiting, confusion, balance issues, LOC, etc., pt is referred to the ER for a CT scan of the head to rule out bleeding.

No

loss of consciousness, confusion, photophobia

Loss of consciousness > 1 min, progression of symptoms, neuro deficits, age/medications

referred to brain injury neurologist nearby

Older pts.with concussive sx esp those on bld thinners are referred to the ED for further eval and treatment

Amnesia, Confirmed Loss of Consciousness, presistent vomiting. Persistant or newly developed neurologic symptoms / impairment such as balance, vision, memory difficulty.
All referred to Sports medicine specialist for testing before return to play