@article{ref1,
title="The "headstrike" protocol: a retrospective review of a single trauma center's operational change in the management of anticoagulated ground-level falls",
journal="American surgeon",
year="2019",
author="Keyes, Michael and Alley, Ashley and Muertos, Keely and Anderson, Barbie and Howerton, Stephanie and Burns, Alison and Pepe, Antonio",
volume="85",
number="8",
pages="821-829",
abstract="Anticoagulated older adults suffering ground-level falls are a specialty trauma population at risk for intracranial hemorrhage (ICH). Delays in diagnosis or initiation of anticoagulation reversal can lead to increased morbidity/mortality. A novel &quot;Headstrike&quot; protocol was implemented to improve the treatment efficacy and disposition of these patients. The study objective was to determine effectiveness of the &quot;Headstrike&quot; protocol in providing these patients with timely treatment and disposition, while maintaining positive outcomes. A trauma performance improvement database was queried for all &quot;Headstrike&quot; activations for a 12-month period after implementation. Demographics, patient care, and health data were collected. Descriptive statistics were used for cohort analysis. Five hundred fifteen patients were activated as a &quot;Headstrike&quot; during the study period. Thirty eight patients were diagnosed with ICH (7.4%), 35 of whom were identified on initial imaging. Anticoagulation reversal was ordered for 84.6 per cent of these patients. Of the patients with negative initial CT, only three patients (0.8%) were found to have a delayed ICH on routine follow-up imaging. No anticoagulant/antiplatelet agent was associated with a significantly higher risk of ICH. Implementation of the &quot;Headstrike&quot; protocol resulted in trauma service line resources being used more efficiently, while ensuring high-quality, expeditious care to this population.<p /> <p>Language: en</p>",
language="en",
issn="0003-1348",
doi="",
url="http://dx.doi.org/"
}