Quick Detection Of Brain Bleeding Saves Lives
A treatment strategy for people on blood thinners who hit their head is saving lives at Beaumont Hospital, Royal Oak (Mich.), according to recent research.
In 105 study patients treated under the protocol, the time to diagnose bleeding in the brain as a result of the head bump was cut in half and treatment was started in one-third of the previous time. The death rate was reduced from 40 percent to 11 percent as a result.
The protocol includes rapid initial evaluation by a nurse and doctor, a CT scan of the head done on a priority basis, a blood transfusion and administration of vitamin K, which helps the blood to clot.
"These seem like relatively simple steps, but when combined they become a powerful force that helps save lives," says Greg Howells, M.D., director, Trauma Surgery.
The average age of the patients in the Beaumont study was 78. About 60 percent were men and about 40 percent were women. Most (88 percent) hit their head by falling. Many of these people can appear normal and the bleeding can't be detected by physical examination or laboratory studies.
"Unfortunately, falls in older people are all too common and can be easily dismissed as a minor occurrence or even an embarrassing one," says Mario Vilallba Jr., M.D., a general surgery resident (doctor-in-training) who recently presented the research at a regional meeting of the American College of Surgeons. "But this research stresses that for people on blood thinners, prompt medical attention can be crucial."
Trauma surgeons at Beaumont started a campaign almost four years ago urging people who are on a blood thinner to get immediate medical attention if they hit their head. They took this step after their previous research showed that the chance of dying from a blow to the head increases four times the normal rate for people on blood thinners.
Word of the Beaumont protocol is spreading. More than forty other hospitals from across the country have asked about Beaumont's treatment protocol for people on blood thinners who hit their head.
People usually take blood thinners because they've had a heart attack or stroke, in an effort to prevent another one.
Beaumont Hospital, Royal Oak is the only Level 1 trauma center in Oakland and Macomb counties. Being a Level 1 trauma center means the hospital has the highly trained staff, systems and equipment in place to treat even the most serious injuries at any time.