Major head injury study launched by NEAS
Research backed by UK's leading brain charity.
An important new research trial investigating whether patients
with serious head injuries should be taken to their nearest
hospital or a specialist neurological centre has been launched in
the North East.
The study is being conducted by NEAS and the North West
Ambulance Service, with funding provided by the Health Technologies
Assessment Programme (HTA).
The study is ground-breaking research involving three
specialist neurosurgical centres and 11 general hospitals.
In the North East eight general hospitals are taking part in the
trial as well as two neurosurgical centres based at the James Cook
University Teaching Hospital in Middlesbrough, and at the Royal
Victoria Infirmary in Newcastle.
Over 900 NEAS staff based at 46 ambulance stations in the North
East will be involved.
Although it is widely accepted that patients with severe
Traumatic Brain Injury ("TBI") should be managed in neurosurgical
centres it is uncertain whether it is beneficial for paramedics to
take these patients past the nearest general hospital emergency
department (if that hospital does not have neurosurgery on
Doing so may delay stabilisation of the patient's airway - but
could reduce the time a patient needs to wait for neurosurgery.
This issue has recently been debated in the national media and
patients with serious head injuries have been used as an example
where travelling a longer distance to a specialist hospital could
be in the patients' interest.
However, the National Institute for Health and Clinical
Excellence (NICE) recently decided that current evidence for
bypassing the nearest hospital in favour of a specialist centre was
inconclusive, and stated that this is an important issue in need of
During the trial two randomised approaches will be followed by
Patients will either be transferred to the nearest hospital
A&E department, or transferred directly to a specialist
It's important to stress that patients in each section of the
trial will continue to receive the best available care from the
moment of injury.
During this feasibility study the research team will evaluate
how well ambulance service crews are able to comply with the study
protocol before a larger full-scale trial is designed.
The research team will also measure patients' survival and
health over the following six months to detect if either approach
leads to better outcomes for patients during the feasibility study,
although this is expected to only become apparent in a full
The research team includes experts in emergency care research,
ambulance services, A&E, neurosurgery, health economics and
statistics, and patient and public representatives.
Collaborating academic institutions include the School for
Health and Related Research (ScHARR) at Sheffield University, where
the Chief Investigator, Professor Fiona Lecky is based, and the
University of Manchester who are sponsors of this research.
The trial is supported by Headway, a registered charity that
works to improve life after brain injury. An independent ethics
committee, the North Wales Research Ethics Committee (Central and
East), has reviewed the research plans to ensure that the interests
of patients are paramount throughout and have granted approval for
The trial is described in more detail in a dedicated website
which can be accessed at: www.hits-ns.tarn.ac.uk