Bosley L, Dobson G, Letson H, McCartney E, Gibbs C
1James Cook Unviersity
Biography:
Dr Lauren Bosley is a Resident Medical Officer at Townsville University Hospital with a strong interest in critical care and research. She completed a two-year Honours thesis during her medical degree, which focused on the retrieval of traumatic brain injuries. Having grown-up in Hervey Bay, Dr Bosley is passionate about advocating for equitable healthcare for nonmetropolitan communities.
In addition to her clinical role, Dr Bosley is an Academic at James Cook University, where she has taught medical students for over six years. This year, she extended her teaching experience by lecturing at her hospital’s mandatory intern teaching program.
Abstract
Background: Traumatic Brain Injury (TBI) patients require time-critical treatment. Whilst aeromedical retrieval is available nation-wide, literature is scarce regarding the retrieval of TBI patients in Queensland.
Aims: This study analysed the retrieval of TBI patients who were transferred by Retrieval Services Queensland (RSQ) to a Queensland neurosurgical centre. Secondary aims were to investigate the prevalence of clinically raised intracranial pressure (ICP) during retrieval, the proportion of patients who had neurosurgery, and TBI-related mortality.
Method: Retrospective linked data from Queensland Ambulance Service, RSQ, and Queensland Health Admitted Patient Data Collection identified TBI patients retrieved between January 1, 2018 and December 31, 2023, who were admitted to a Queensland neurosurgical centre.
Results: Of the total 1046 patients examined, 75% were male, 10% were Indigenous, and two-thirds were from regional areas. On retrievalist arrival, 25% of patients were defined as severe, with a further 20% at time of neurosurgical admission. The median transfer time for these patients was 4.12 hours, with only 8.5% transferred within the recommended two hours. Seven patients were operated on by non-neurosurgeons. Clinical signs of raised ICP were uncommon, with nonreactive pupils in 13.9% and Cushing’s response in 2.7% of cases. Overall mortality was 20%, with no statistical difference with rurality.
Conclusions: In Queensland, young Indigenous males from regional areas have the greatest prevalence of aeromedical retrievals for TBI. Over 90% of severe TBI patients had transfer times exceeding the Australian Rural Neurotrauma guidelines, which highlights a potential need for non-neurosurgeon interventions to reduce secondary injury and improve outcomes.