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.

Head injury

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 site).

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 further study.

During the trial two randomised approaches will be followed by NEAS paramedics.

Patients will either be transferred to the nearest hospital A&E department, or transferred directly to a specialist neurosurgical centre.

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 trial.

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 this research.

The trial is described in more detail in a dedicated website which can be accessed at: www.hits-ns.tarn.ac.uk

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