The AHEAD Study; scan all head injuries on warfarin??

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 16 January 2017

⏱️ 17 minutes

🔗️ Recording | iTunes | RSS

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Summary

Those of us who are a bit longer in the tooth have spent most of our careers not scanning everyone who sustained a head injury on warfarin, but in 2104 NICE published guidance suggesting we do just that.

At times, with the huge burden we place on our radiology services, it is difficult not think we're over doing things with all of these scan requests, especially when the patient has no adverse symptoms or signs. Fortunately the AHEAD study has just been published which looks at thousands of patients presenting to ED's on warfarin with a head injury.

The paper is open access and deserves a full read, in this podcast I run through some of the main parts of the study and have a think about how it might impact on our practice.

This is just one part of the puzzle on the management of patients with anticoagulated head injuries, we had a look previously on what to do if you perform a scan and that appears normal in our Anticoagulation, Head Injury & Delayed Bleeds Podcast.

Hope you enjoy the podcast and we'd love to hear any of your feedback on social media or on the website.

Simon

Transcript

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0:00.0	Welcome to the Recess Room podcast.
0:03.9	Five, four, three, two, one, fire.
0:12.5	Hi, and welcome back to the Recess Room podcast. I'm Simon Lang and I am Billy Naimates tonight.
0:19.4	There's no Rob Fenwick.
0:23.8	Allegedly, he's got better things to do on a Saturday evening and sit in front of a microphone and chat evidence-based medicine.
0:28.0	But I'm sure he'll soon work out the error of his ways.
0:31.5	So it's just me talking to you on my own, but it's definitely worthwhile.
0:37.0	Because there's a big paper that's just come out.
0:39.7	I've been waiting for for quite a while that looks at the topic that comes in through
0:44.4	LEDs really often, and that's on anti-coagulated head injuries, specifically warfarin, and the
0:51.4	need to perform a CT head.
0:57.5	So the paper's title is the ahead study and observational study of the management of anti-coregulated patients who suffer a head
1:03.9	injury. It has just been published in the BMJ and it's available online in its full format.
1:11.1	Now rather than listen to this podcast, the best thing that you could do
1:15.3	be to have a read through the paper.
1:17.6	It is a really easy, really good read.
1:20.4	It's published from a great set of clinicians based up in Sheffield.
1:23.8	The lead author was Sue Mason.
1:25.8	But if you haven't had a chance to have a look at it yet,
1:28.2	then in this podcast we're just going to run through the main findings and have a think
1:32.6	about how it actually relates to our clinical practice and if it's going to change what we do.
1:39.2	So to those of us that have been involved in emergency medicine for a little bit longer,
	...

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