PDF(Pubmed)
Abstract：
BACKGROUND: Traumatic brain injury (TBI) is a common presentation in the prehospital environment. At present, paramedics do not routinely use tools to identify low-risk patients who could be left at scene or taken to a local hospital rather than a major trauma centre. The Canadian CT Head Rule (CCHR) was developed to guide the use of CT imaging in hospital. It has not been evaluated in the prehospital setting. We aim to address this gap by evaluating the feasibility and acceptability of implementing the CCHR to patients and paramedics, and the feasibility of conducting a full-scale clinical trial of its use.
METHODS: We will recruit adult patients who are being transported to an emergency department (ED) by ambulance after suffering a mild TBI. Paramedics will prospectively collect data for the CCHR. All patients will be transported to the ED, where deferred consent will be taken and the treating clinician will reassess the CCHR, blinded to paramedic interpretation. The primary clinical outcome will be neurosurgically significant TBI. Feasibility outcomes include recruitment and attrition rates. We will assess acceptability of the CCHR to paramedics using the Ottawa Acceptability of Decision Rules Instrument. Interobserver reliability of the CCHR will be assessed between paramedics and the treating clinician in the ED. Participating paramedics and patients will be invited to participate in semistructured interviews to explore the acceptability of trial processes and facilitators and barriers to the use of the CCHR in practice. Data will be analysed thematically. We anticipate recruiting approximately 100 patients over 6 months.
BACKGROUND: This study was approved by the Health Research Authority and the Research Ethics Committee (REC reference: 22/NW/0358). The results will be published in a peer-reviewed journal, presented at conferences and will be incorporated into a doctoral thesis.
BACKGROUND: ISRCTN92566288.
METHODS: We will recruit adult patients who are being transported to an emergency department (ED) by ambulance after suffering a mild TBI. Paramedics will prospectively collect data for the CCHR. All patients will be transported to the ED, where deferred consent will be taken and the treating clinician will reassess the CCHR, blinded to paramedic interpretation. The primary clinical outcome will be neurosurgically significant TBI. Feasibility outcomes include recruitment and attrition rates. We will assess acceptability of the CCHR to paramedics using the Ottawa Acceptability of Decision Rules Instrument. Interobserver reliability of the CCHR will be assessed between paramedics and the treating clinician in the ED. Participating paramedics and patients will be invited to participate in semistructured interviews to explore the acceptability of trial processes and facilitators and barriers to the use of the CCHR in practice. Data will be analysed thematically. We anticipate recruiting approximately 100 patients over 6 months.
BACKGROUND: This study was approved by the Health Research Authority and the Research Ethics Committee (REC reference: 22/NW/0358). The results will be published in a peer-reviewed journal, presented at conferences and will be incorporated into a doctoral thesis.
BACKGROUND: ISRCTN92566288.
摘要：
背景：创伤性脑损伤（TBI）是院前环境中的常见表现。目前,护理人员通常不会使用工具来识别可能留在现场或被送往当地医院而不是主要创伤中心的低风险患者。制定了加拿大CT头目规则（CHR），以指导医院CT成像的使用。尚未在院前环境中进行评估。我们的目标是通过评估对患者和护理人员实施CCHR的可行性和可接受性来解决这一差距，以及对其使用进行全面临床试验的可行性。
方法：我们将招募患有轻度TBI后被救护车送往急诊科（ED）的成年患者。护理人员将前瞻性地收集CCHR的数据。所有患者将被送往急诊室，在延期同意的情况下，治疗临床医生将重新评估CCHR，对护理人员的解释视而不见。主要临床结果将是神经外科重要的TBI。可行性结果包括招聘和流失率。我们将使用渥太华决策规则工具评估CHR对护理人员的可接受性。CHR的观察者间可靠性将在护理人员和ED中的治疗临床医生之间进行评估。参与的护理人员和患者将被邀请参加半结构化访谈，以探索试验过程和促进者的可接受性以及在实践中使用CHR的障碍。数据将按主题进行分析。我们预计在6个月内招募约100名患者。
背景：本研究获得了健康研究机构和研究伦理委员会的批准（REC参考：22/NW/0358）。结果将发表在同行评审的期刊上，在会议上提出，并将被纳入博士论文。
背景：ISRCTN92566288。
方法：我们将招募患有轻度TBI后被救护车送往急诊科（ED）的成年患者。护理人员将前瞻性地收集CCHR的数据。所有患者将被送往急诊室，在延期同意的情况下，治疗临床医生将重新评估CCHR，对护理人员的解释视而不见。主要临床结果将是神经外科重要的TBI。可行性结果包括招聘和流失率。我们将使用渥太华决策规则工具评估CHR对护理人员的可接受性。CHR的观察者间可靠性将在护理人员和ED中的治疗临床医生之间进行评估。参与的护理人员和患者将被邀请参加半结构化访谈，以探索试验过程和促进者的可接受性以及在实践中使用CHR的障碍。数据将按主题进行分析。我们预计在6个月内招募约100名患者。
背景：本研究获得了健康研究机构和研究伦理委员会的批准（REC参考：22/NW/0358）。结果将发表在同行评审的期刊上，在会议上提出，并将被纳入博士论文。
背景：ISRCTN92566288。
