This guideline covers the assessment and early management of head injury in children, young people and adults. It promotes effective clinical assessment so that people receive the right care for the severity of their head injury, including referral directly to specialist care if needed.
In September 2019, we changed our advice to indicate that adults and children who are on any anticoagulant (not just warfarin) should have a CT head scan within 8 hours of head injury.
This guideline includes recommendations on:
- Pre-hospital assessment and advice, and immediate management at the scene
- Assessment in the emergency department
- Investigating clinically important brain injuries and injuries to the cervical spine
- Information and support for families and carers
- Transfer from hospital to a neuroscience unit
- Admission and observation
- Discharge and follow-up
Who is it for?
- Healthcare professionals
- People with head injury, their families and carers.
Is this guideline up to date?
We checked this guideline in September 2019 and we are updating the recommendations on head CT scans in people on anticoagulant treatment, diagnosis and management of post head injury hypopituitarism, and management of indirect brain injuries (not caused by direct trauma in the head).
Guideline development process
This guideline updates and replaces NICE guideline CG56 (September 2007).
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.