"Loss of Consciousness"

[Kaisu]

Dfib.. I think he means loss of consciousness as opposed to level of consciousness

[DFIB]

Dfib.. I think he means loss of consciousness as opposed to level of consciousness

True but if is addressed in the initial assessment and at any point they are or become unconscious it would mark a significant change in the patients state and be significant in the continued assessment.

To be honest I am not sure exactly what he is getting at.

.

[nypamedic43]

I'm still confused as to what trauma "triage" protocols he is referring to. As mobey and DFIB have pointed out, triage in trauma referrs to an MCI and determining immediate life threats. And, as has also been pointed out, everyone has different protocols.

[craig]

here is the ASNSW protocol for head injury in trauma

ASNSW trauma protocol for head injury

Category: Protocols

Last Updated Dec 28 2011 07:40 AM

[romneyfor2012]

I believe any trauma patient with loss of consciousness should go to a hospital with neuro capabilities (not necessarily trauma center), just as I believe any medical patient who has experienced syncope should be transported. It is not normal to be unconscious, just because they seem fine now, is not a good enough indicator for me to get a refusal and leave them behind.

The reason Docs are hung up on it, is that it is often very difficult to get neuro patients transferred, especially if they are uninsured. By taking neuro patients to non-neuro hospitals, you create more work for the ER.

[ERDoc]

Romney, any doc that gets hung up on it for the reason that they give you is FOS. Most pts who report a loss of consciousness or actually have a loss of consciousness do not need a neuro or neurosurg consult. They get a CT and if neg, either observation or discharge with appropriate instructions depending on a few other factors. Docs want to know about loss of consciousness because it will influence if the pt needs a CT scan or not. http://www.pecarn.org/documents/kuppermann_2009_the-lancet.pdf That is a recent article on pediatric head injuries. As you can see, loss of consciousness is one factor in determining the need for a head CT.

As I have said before, some of it depends on the type of doc you have in the ER. If you have a non-residency trained FM, IM, Surg, etc then they probably do not stay up to date on the latest EM literature.

[Vorenus]

LOC is an essential aspect in START and SALT triage (just to name some prominent examples), as well as it`s an important factor in ANY anamnesis, regardless of the diagnose.

Edited December 28, 2011 by Vorenus

[nypamedic43]

LOC is an essential aspect in START and SALT triage (just to name some prominent examples), as well as it`s an important factor in ANY anamnesis, regardless of the diagnose.

Again MCI triage protocols. These do not apply to single patients where they get a full trauma assessment. Not the very abbreviated and fast MCI triage tags of black, red, yellow and green.

[Bieber]

Our trauma triage protocols mandate any patient who suffered from a loss of consciousness greater than five minutes be transported as a level II trauma patient to one of our trauma hospitals. But our trauma triage protocols aren't that great, in fact they're pretty much entirely MOI based with the exception of that one.

[Vorenus]

Again MCI triage protocols. These do not apply to single patients where they get a full trauma assessment. Not the very abbreviated and fast MCI triage tags of black, red, yellow and green.

Ah... I only kinda slipped through the thread. You`re right of course.

Regarding that matter, it of course depends on your local protocols.