Management of acute traumatic intracranial haematoma in rural and remote areas of Australia

Gilligan, J. E.; Reilly, Peter; Péarce, Andrew; Taylor, Danielle

doi:10.1111/ans.13583

Cited by 16 publications

(21 citation statements)

References 21 publications

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“…Furthermore, transit complications whether by helicopter or fixed wing aircraft have been reported to be uncommon. 34 35 Our department in fact has a similar agreement with the local surgeons. Since they already have more than 5 years of experience assisting in neurosurgical operations, if ever the need arises for such a rapid treatment where the patient simply cannot wait for the neurosurgeon to arrive from Zagreb (for example, patients with epidural hematomas with such a sharp decline in their neurologic status), these surgeons, as well as the OR staffs are more than capable of positioning the patient, starting the procedure, and performing the emergency craniotomy.…”

Section: Discussionsupporting

confidence: 59%

The Dubrava Model—A Novel Approach in Treating Acutely Neurotraumatized Patients in Rural Areas: A Proposal for Management

Orešković

Raguž

Almahariq

et al. 2019

Journal of Neurosciences in Rural Practice

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Introduction Neurotrauma is one of the leading causes of death and disabilities nowadays and represents one of the largest socioeconomic problems in rich countries, as well as developing ones. A satisfying, medically viable, and cost-effective model of managing acutely neurotraumatized patients, especially ones who come from distant and/or rural areas, has yet to be found. Patient outcome after acute neurotrauma depends on many factors of which the possibility of urgent treatment by an experienced specialist team has a crucial role. Here, we present our own way of managing acutely neurotraumatized patients from distant places which is unique in Croatia, the Dubrava model. Methods We present our 5-year experience cooperating with general hospitals in four neighboring cities (Ĉakovec, Bjelovar, Sisak, and Koprivnica) in managing, operating, and taking care of acutely neurotraumatized patients. Results More than 300 surgeries have been performed in these hospitals through the Dubrava model. Our experience so far provides encouraging results that this system could also be successfully implemented in other institutions. Furthermore, we recorded an increased number of surgeries each year, as well as a good mutual cooperation with the local general hospitals. Discussion This trauma managing model is one of a kind in Croatia. We argue that it is not only better for the patients, providing them with better chances of survival, and disability-free recovery, but is also far superior in many ways to the dominant and currently prevalent way of treating these patients in other parts of Croatia. Conclusion The Dubrava model of treating patients in rural and distant areas is a reliable and proven model with many benefits and as such its implementation should be considered in other institutions as well.

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Section: Discussionsupporting

confidence: 59%

The Dubrava Model—A Novel Approach in Treating Acutely Neurotraumatized Patients in Rural Areas: A Proposal for Management

Orešković

Raguž

Almahariq

et al. 2019

Journal of Neurosciences in Rural Practice

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“…Remarkably, only one patient died. Of the remaining 153 patients, 26 had neurosurgical intervention at Royal Adelaide Hospital with 46% mortality 8 . Of interest was the ability of the neurosurgery team to be in attendance in an emergency on‐the‐spot operation.…”

Section: Discussionmentioning

confidence: 99%

“…Of the remaining 153 patients, 26 had neurosurgical intervention at Royal Adelaide Hospital with 46% mortality. 8 Of interest was the ability of the neurosurgery team to be in attendance in an emergency on-the-spot operation. McMonagle et al reviewed trauma patients transported by the air retrieval service in NSW between 1999 and 2003.…”

Section: Discussionmentioning

confidence: 99%

Is neurotrauma training in rural New South Wales still required following the implementation of the New South Wales State Trauma Plan?

Vessey

Shivapathasundram

Francis

et al. 2021

ANZ Journal of Surgery

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Background: In New South Wales (NSW), Australia, trauma accounts for 6% of deaths. Trauma patients receiving definitive care in regional trauma centres are 34% more likely to have a fatal outcome compared to level 1 centres. Following the implementation of the NSW State Trauma Plan where patients with major trauma are fast tracked to regional trauma services, should NSW rural surgeons and retrieval doctors continue to receive surgical training in neurotrauma? Methods: The study's primary objective was to ascertain which NSW regional and rural hospitals have the equipment to perform neurotrauma and when it was last used. The study also examined the outcome of those patients who had undergone an emergency neurosurgical procedure. Results: Of the 149 regional and rural hospitals in NSW, 16 stored a Hudson brace, perforator, burr and Gigli saw sterile and ready to use in the operating theatre. Only one hospital utilised the equipment in the last year and 11 in the last 10 years. Of those patients who had undergone an emergency neurosurgical procedure, two patients died prior to transfer and three were confirmed deceased after transfer to a tertiary centre. Conclusion:The implementation of the NSW State Trauma Plan has streamlined the trauma triage process and transport of neurotrauma patients to regional and major trauma services. However, it is likely that knowledge of how to perform burr hole and craniectomy for the evacuation of extradural haematoma remains a useful skill for the rural surgeon and retrieval doctor if transport is delayed.

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“…Zahlreiche Studien untersuchten die Ergebnisse von Allgemeinchirurgen, die ein SHT operativ versorgten und konnten vergleichbare Ergebnisse für die Versorgung von Subdural-und Epiduralhämatomen zeigen [20,29].…”

Section: Geographischer Einfluss Auf Das Outcomeunclassified

Polytrauma und begleitendes Schädel-Hirn-Trauma

2017

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Management of acute traumatic intracranial haematoma in rural and remote areas of Australia

Cited by 16 publications

References 21 publications

The Dubrava Model—A Novel Approach in Treating Acutely Neurotraumatized Patients in Rural Areas: A Proposal for Management

The Dubrava Model—A Novel Approach in Treating Acutely Neurotraumatized Patients in Rural Areas: A Proposal for Management

Is neurotrauma training in rural New South Wales still required following the implementation of the New South Wales State Trauma Plan?

Polytrauma und begleitendes Schädel-Hirn-Trauma

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