Pathway for Referral of Patients with Traumatic Brain

Pathway for Referral of Patients with Traumatic Brain Injury, Subarachnoid Haemorrhage or other Neuro-Surgical Emergency to the Neurosurgical Services at Brighton and Sussex University Hospitals Start Referral to Neurosurgical Sp. R to discuss with neurosurgical Consultant on call If patients not admitted, they will be Discussed with radiology at morning meeting Patient needs ward or ICU Bed Arrange for ward admission Via RSCH site management Team Advise referral To another centre WARD Audit point NO ADVICE TO BE GIVEN TO REFERRING CENTRE IF NO BED AVAILABLE The patient remains the responsibility of the referring hospital until transfer is complete • Referrer must inform local responsible Consultant of bed problem and get their support, BOTH local Surgical and ICU input is recommended • Neurosurgical Registrar and Consultant will facilitate looking for another Neurosurgical centre, contact EBS 02074077181 • Doctors in the referring hospital should keep close observation of patient pending transfer • Regular contact by the referring hospital to update BSUH Neurosurgery of progress and condition is recommended • The Neurosurgical Consultants and L 5 ICU Consultant are available to provide further discussion and advice NOTE: the patients condition may change and may need complete review by this pathway ICU Is ICU bed available Confirm with L 7 shift leader NO Is urgent admission required *(Box A) YES Audit point Is emergency, time critical lifesaving surgery required? *(Box A) YES Audit point Inform L 7 ICU nurse in charge, ICU registrar and ICU Consultant on call for L 5 that urgent admission Is required for this patient Inform L 7 ICU nurse in charge, ICU registrar and ICU Consultant on call for L 5 that emergency is being admitted Under Neurosurgical Society rules Arrange admission of referred Patient to L 5 ICU team to activate bed escalation policy * BOX A 1. Must be discussed with Neurosurgical Consultant 2. This may need further Consultant-to-Consultant discussion with: • Referring Hospital Consultant • ICU L 5 Consultant • Anaesthetic Consultant Author: Dr Boyd and Mr Critchley, version March 2017 YES Is it possible to plan for admission of patient Review date: March 2019 Plan for admission Direct to operating theatre YES Inform anaesthetic, surgical and Theatre team NO Inform L 7 ICU nurse in charge, ICU registrar and ICU Consultant on call for L 5 all need to agree to admission Useful Contacts: Royal Sussex County Hospital: 01273696955 Neuro-surgical Sp. R: 62032 ICU Sp. R: bleep via switch 8413 ICU nurse in charge L 7: 62008 ICU Nurse in charge L 5: 62015 Neurosurgical Consultant: via switch ICU Consultant L 7: 62036 or via switch ICU Consultant L 5: 62035 or via switch NO ICU team to activate bed escalation policy, May need to consider ‘treat and transfer’ Neurosurgical Sp. R to discuss with neurosurgical Consultant on call, And ICU L 5 Consultant to assess urgency, stability, Etc of patient Advise referral To another centre Audit point NO Is emergency, time critical lifesaving surgery required?