ED registrar Dr Alice Rogan has been investigating the use of blood biomarkers as a test to rule out severe traumatic brain injury. Photo / Supplied
ED registrar Dr Alice Rogan has been investigating the use of blood biomarkers as a test to rule out severe traumatic brain injury. Photo / Supplied
Research under way at Wellington's overflowing emergency department aims to cut down the number of patients that need a CT head scan.
Carried out in a pilot study at Te Pae Tiaki Wellington ED and the Hutt Hospital ED, researchers are investigating whether traumatic brain injury (TBI) can be ruled out using a blood test.
In the first study of its kind in Australasia, blood biomarkers taken from people presenting with head injuries could be used to decide if the patient required a CT scan.
Emergency department registrar Dr Alice Rogan had been working on the study for more than a year, and hoped the findings could ease the flow at the region's emergency departments, which had been at capacity for months.
"It would certainly help things slow in ED, so certainly people would hopefully get seen quicker, get scans quicker and get to neurosurgery if that's required or just admitted to hospital if that's required," she said.
"We can have more rapid identification of those patients that do need to come and have head CT scans."
"And I think on a local level in Wellington if we can just improve the clinical flow even for those that don't need a CT that can then get home quicker and spend less time waiting."
Wellington's emergency departments had been under continued pressure for months. Photo / 123rf
The region's hospitals have been under continued pressure since March, with an outbreak of respiratory illness this month further pushing up ED wait times.
CT head scans were used on patients presenting with head injuries, to determine if they had bleeding or swelling - a sign of traumatic brain injury.
Rogan said requests for CT scans were increasing, though of the patients who had them, only around 10 per cent had serious injuries identified.
"When the brain is injured, biomarkers are released into the blood stream and can be measured," she said.
"If blood biomarker levels are not raised, we would not expect to see any injury on CT, and therefore the new pathway would recommend not to perform a head CT."
"If we can better target who needs them and the people that do have injuries get CT heads faster, that's going to be better for everyone."
In the early stage of the research, patients presenting to Wellington hospitals requiring a CT scan were asked to consent to a blood test, to determine the relationship between blood biomarkers and the injuries observed in a CT scan.
Almost 300 people had already taken part in the study, and Rogan was hoping for 1000 more by the end of next year.
No other emergency department in Australasia was investigating the use of blood biomarkers, but international research had shown them to be useful elsewhere in the world.
"One of the issues here is that we've got a really different population and we use slightly different rules and our healthcare system's different, so we really need to show that it's safe."
"But we estimate that we can reduce the demand for CTs in trauma by about 30 per cent if things work and that's certainly what data from other centres has shown."
