Prehospital Assessment Tools in Traumatic Brain Injury v1.0
Research type
Research Study
Full title
Investigating neurological assessment tools in the prehospital hyperacute phase of traumatic brain injury and the association with initial assessment and outcome.
IRAS ID
336094
Contact name
Laurie Phillipson
Contact email
Sponsor organisation
Queen Mary University of London
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
Sixty-nine million individuals are estimated to suffer Traumatic Brain Injury (TBI) each year and there were 356,699 UK admissions to hospital with acquired brain injury in 2019-20. Whilst advances have been made in other areas of healthcare, mortality rates from TBI have remained static in recent decades and clinical progress has not kept pace with the rising global burden.
Compared with monitoring modalities available to the neuro-intensive care unit, prehospital monitoring is crude and there are many aspects of patient physiology or pathology which are unreported and therefore unavailable to guide clinical decision-making. To make progress in the arena of TBI care, prehospital clinicians need to be able to stratify brain injury and identify neurological emergencies in the hyperacute phase to optimise treatment and triage decisions.
The Essex and Herts Air Ambulance (EHAAT), a Helicopter Emergency Medical Service (HEMS) operating 2 helicopters and a rapid response car in the East of England, will fund a study aiming to investigate the characteristics and outcomes of patients with suspected TBI who receive prehospital neuromonitoring. Pupillometry (the measurement of pupil size and its change in response to light), optic nerve sheath diameter measurement using a portable ultrasound device over a closed eyelid, and point-of-care analysis of two TBI blood biomarkers in a small sample of the patient's blood taken from an unflushed cannula, will be assessed by EHAAT clinicians in patients with known or suspected TBI for a period of 12-months. These modalities are not commonly available prehospital.
Patient physiology, neuromonitoring data, CT results and outcomes will be compared to examine associations. This will be beneficial in determining whether the devices can assist clinical decision making and identify those most at risk of adverse outcomes.
REC name
London - Bromley Research Ethics Committee
REC reference
25/LO/0687
Date of REC Opinion
24 Sep 2025
REC opinion
Favourable Opinion