Management of patients with mild head injury in Australian Emergency Departments: The Neurotrauma Evidence Translation (NET) Trial

Head injury is a very common presentation to emergency departments (EDs). Up to 15% of patients with mild head injury experience persistent disabling problems (e.g. reduced cognitive and functional ability, heightened emotional distress, and delayed return to work or school). As the ED is the main, and often only, point of medical contact for these patients, the care they receive in the ED can impact on these patients’ outcomes. The NET-Trial is a cluster randomised trial which aims to test the effectiveness of a targeted, theory and evidence-informed implementation intervention regarding the management of adult mild head injured patients in the ED in Australia. Three recommendations from clinical practice guidelines have been selected as the focus of the study and they are 1) prospective assessment for post traumatic amnesia (PTA) using a validated tool; 2) appropriate computed tomography (CT) scanning based on risk criteria; and 3) the provision of patient information upon discharge from the ED. The 3 key evidence-based recommendations have been decided after a systematic review of the evidence and available clinical guidelines, and consultation with the ED community. EDs will be randomised to receive either the intervention or to a control group who will have access to the clinical practice guideline alone. The control group will be offered to receive the intervention component of the study following data collection. In addition, EDs will be invited to participate in the “NET-Plus” trial that also includes patient outcomes to investigate whether improved management as a result of our intervention is translated into improved patient outcomes.