Walters K A
Department of Neurosurgery, Pinderfields Hospital, Wakefield.
Arch Emerg Med. 1993 Mar;10(1):29-34. doi: 10.1136/emj.10.1.29.
The decision to transfer a patient with a head injury to a neurosurgical department is usually made during a referral telephone call. The referring doctor describes the patient's condition to the neurosurgeon who then decides whether or not the patient needs to be transferred. Failure to inform the neurosurgeon adequately, may result in a disastrous decision to transfer an unstable patient. Alternatively, a patient who needs urgent neurosurgical care may not be transferred. This study assessed the information volunteered by 50 doctors referring head-injured patients. Extra information obtained on request was recorded separately. The referring doctor often failed to provide important information. For example, only 17 doctors volunteered the pulse rate, 16 the blood pressure and six the respiratory rate. Furthermore, the Glasgow Coma Scale was under-used and apparently not understood properly. This may hinder the decision to transfer a patient. A standard referral data sheet is recommended.
将头部受伤患者转至神经外科的决定通常是在转诊电话中做出的。转诊医生向神经外科医生描述患者的病情，然后由神经外科医生决定患者是否需要转院。如果没有充分告知神经外科医生相关情况，可能会导致做出将不稳定患者转院的灾难性决定。或者，需要紧急神经外科治疗的患者可能无法被转院。本研究评估了50位转诊头部受伤患者的医生主动提供的信息。应要求获取的额外信息单独记录。转诊医生常常未能提供重要信息。例如，只有17位医生主动提供了脉搏率，16位提供了血压，6位提供了呼吸频率。此外，格拉斯哥昏迷量表使用不足，而且显然没有被正确理解。这可能会妨碍做出转院的决定。建议使用标准转诊数据表。
