Royal Infirmary of Edinburgh

Hospital A&E Information

Head injured patients requiring observation are taken to the Combined Assessment (CA) unit under the care of the A & E consultant, for up to 6 hours (this is not classed as an admission). Combined Assessment nurses are trained in neurological observation and manage patients according to a protocol including arranging discharge. They arrange CT scans and contact the A & E doctor if issues arise or neurological advice is required. Those at higher risk (e.g. elderly, those on warfarin) are observed for longer periods of up to 24 hours in the CA unit under the auspices of the general surgeon on call, who determines their future management and placement after 24 hours.

Those discharged directly from CA are provided with written information and a letter is sent to the GP. There is no routine follow-up and onward referral to rehabilitation is rare.

Reviews, Plans and Strateigies

NHS Lothian and the four local authorities recently agreed the Lothian Joint Physical & Complex Disability Strategy which refers to acquired brain injury.

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