Head injury: assessment and early management—summary of updated NICE guidance
Sharangini Rajesh, David Wonderling, Ian Bernstein, Caroline Balson, Fiona Lecky
Abstract
### What you need to know More than 600 000 people attend emergency departments annually in England and Wales with a recent head injury.1 High quality early management for people with head injury can prevent death from secondary brain injury. Traumatic brain injury is the major contributor to death and disability resulting from major trauma. The National Institute for Health and Care Excellence (NICE) first published guidance on the assessment and early management of head injury in babies, children, young people, and adults in 2003 and last updated guidance in 2014.23 The key drivers for this update published in May 2023 include appraisal of new evidence concerning the role of tranexamic acid in people with head injury, the risks of bleeding after head injury in people taking anticoagulation and antiplatelet therapy, and the need to consider hypopituitarism as both an immediate and delayed complication after head injury of any severity. This guideline summary will cover selected recommendations, focusing on those most relevant to primary, pre-hospital and emergency department care. ### Glossary of terms