• Key to evidence statements and grades of recommendations
• Guideline development group
• Notes for users of the guideline
• Abbreviations
• Summary of recommendations
• Summary of paediatric practice points

1. Introduction
   1.1 Background
   1.2 The need for a guideline
   1.3 Remit of the guideline
2. Assessment and classification
   2.1 Assessing the patient
   2.2 The Glasgow Coma Scale and Coma Score
3. Indications for referral to hospital
4. Principles of management
   4.1 Principles of advanced trauma life support
   4.2 Features of head injured patients attending Scottish hospitals
5. Imaging
   5.1 Detection by of traumatic intracranial lesions by imaging
   5.2 Selection of patients for imaging
   5.3 Indications for skull x-ray
   5.4 Indications for head CT
   5.5 Interpretation of images
   5.6 Imaging the cervical spine
6. Admission or discharge?
   6.1 Indications for admission to hospital
   6.2 Indications for discharge from A&E
   6.3 Information and instructions on discharge from A&E
7. Inpatient observation
   7.1 Clinical observation and recording
   7.2 Frequency of observations
   7.3 Frequency of reappraisal
   7.4 Discharge after observation
8. Indications for referral to a neurosurgical unit
   8.1 Reasons for consultation
   8.2 Indications for referral
   8.3 Transfer between a general hospital and a neurosurgical unit
9. Follow up
10. Implications for service delivery
11. Recommendations for audit and research
    11.1 Audit
    11.2 Key indicators of quality of management
    11.3 Recommendations for further research

Annexes

1. Details of the systematic review undertaken for this guideline
2. Example head injury observation chart
3. Advice for a person taking a patient home from A&E
4. Advice for a person allowed home from A&E
5. Observation instructions for parents or carers
6. Advice for a person discharged home after hospital admission
7. Scottish Trauma Audit Group neurosurgical referral letter

• References