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    Emergency Department Time Course for Mild Traumatic Brain Injury Workup

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    Author
    Michelson, Edward A.; Huff, J. Stephen; Loparo, Mae; Naunheim, Rosanne S.; Perron, Andrew; Rahm, Martha; Smith, David W.; Stone, Joseph A.; Berger, Ariel
    Abstract
    Introduction: Mild traumatic brain injury (mTBI) is a common cause for visits to the emergency department (ED). The actual time required for an ED workup of a patient with mTBI in the United States is not well known. National emergency medicine organizations have recommended reducing unnecessary testing, including head computed tomography (CT) for these patients.10 Methods: To examine this issue, we developed a care map that included each step of evaluation of mTBI (Glasgow Coma Scale Score 13-15) – from initial presentation to the ED to discharge. Time spent at each step was estimated by a panel of United States emergency physicians and nurses. We subsequently validated time estimates using retrospectively collected, real-time data at two EDs. Length of stay (LOS) time differences between admission and discharged patients were calculated for patients being evaluated for mTBI. Results: Evaluation for mTBI was estimated at 401 minutes (6.6 hours) in EDs. Time related to head CT comprised about one-half of the total LOS. Real-time data from two sites corroborated the estimate of median time difference between ED admission and discharge, at 6.3 hours for mTBI. Conclusion: Limiting use of head CT as part of the workup of mTBI to more serious cases may reduce time spent in the ED and potentially improve overall ED throughput.
    URI
    http://hdl.handle.net/10342/8511
    Date
    2018-06-13
    Citation:
    APA:
    Michelson, Edward A., & Huff, J. Stephen, & Loparo, Mae, & Naunheim, Rosanne S., & Perron, Andrew, & Rahm, Martha, & Smith, David W., & Stone, Joseph A., & Berger, Ariel. (June 2018). Emergency Department Time Course for Mild Traumatic Brain Injury Workup. , (), - . Retrieved from http://hdl.handle.net/10342/8511

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    MLA:
    Michelson, Edward A., and Huff, J. Stephen, and Loparo, Mae, and Naunheim, Rosanne S., and Perron, Andrew, and Rahm, Martha, and Smith, David W., and Stone, Joseph A., and Berger, Ariel. "Emergency Department Time Course for Mild Traumatic Brain Injury Workup". . . (), June 2018. November 29, 2023. http://hdl.handle.net/10342/8511.
    Chicago:
    Michelson, Edward A. and Huff, J. Stephen and Loparo, Mae and Naunheim, Rosanne S. and Perron, Andrew and Rahm, Martha and Smith, David W. and Stone, Joseph A. and Berger, Ariel, "Emergency Department Time Course for Mild Traumatic Brain Injury Workup," , no. (June 2018), http://hdl.handle.net/10342/8511 (accessed November 29, 2023).
    AMA:
    Michelson, Edward A., Huff, J. Stephen, Loparo, Mae, Naunheim, Rosanne S., Perron, Andrew, Rahm, Martha, Smith, David W., Stone, Joseph A., Berger, Ariel. Emergency Department Time Course for Mild Traumatic Brain Injury Workup. . June 2018; (): . http://hdl.handle.net/10342/8511. Accessed November 29, 2023.
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