TY  - JOUR
PY  - 2019//
TI  - The "headstrike" protocol: a retrospective review of a single trauma center's operational change in the management of anticoagulated ground-level falls
JO  - American surgeon
A1  - Keyes, Michael
A1  - Alley, Ashley
A1  - Muertos, Keely
A1  - Anderson, Barbie
A1  - Howerton, Stephanie
A1  - Burns, Alison
A1  - Pepe, Antonio
SP  - 821
EP  - 829
VL  - 85
IS  - 8
N2  - 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 "Headstrike" protocol was implemented to improve the treatment efficacy and disposition of these patients. The study objective was to determine effectiveness of the "Headstrike" protocol in providing these patients with timely treatment and disposition, while maintaining positive outcomes. A trauma performance improvement database was queried for all "Headstrike" 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 "Headstrike" 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 "Headstrike" 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>
LA  - en
SN  - 0003-1348
UR  - http://dx.doi.org/
ID  - ref1
ER  -