This guideline covers assessment and early management of head injury in babies, children, young people and adults. It aims to ensure that people have the right care for the severity of their head injury, including direct referral to specialist care if needed.
See NICE’s guideline on major trauma service delivery for recommendations on prehospital triage, transfer and pre-alert procedures, procedures for receiving people in trauma units and major trauma centres, documentation, monitoring and audit, and access to major trauma services.
This guideline includes new and updated recommendations on:
- decision making and mental capacity
- immediate management at the scene and transport to hospital
- assessment in the emergency department
- investigating clinically important traumatic brain injuries
- investigating injuries to the cervical spine
- transfer from hospital to a neuroscience unit
- admission and observation
- discharge and follow up
It also includes recommendations on:
- pre-hospital assessment, advice and referral to hospital
- information and support for families and carers
Who is it for?
- Healthcare professionals
- People with a head injury, their families and carers
- Commissioners and providers
Guideline development process
This guideline updates and replaces NICE guideline CG176 (January 2014).
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.