Published on: Friday, July 30, 2010 |
Kota Kinabalu: The Queen Elizabeth Hospital (QEH) and hospitals in the five divisions (Tawau, Sandakan, Kudat, West Coast and Interior) as well as in the 23 districts attend to some 1,500 cases of traumatic brain/head injury yearly.
QEH Neurosurgeon Dr Gunasegaran said of the figure, about 350 get operated on each year.
"All of them are normally placed at the Intensive Care Unit (ICU).
While the severe cases are handled by the QEH Neuro Centre, the only such centre in the State. Doctors in district hospitals are trained to do simple neurotrauma surgery," he told Daily Express.
The Borneo Neurosurgery Conference and 3rd Neurosurgical Paramedic and Nursing Conference kicked off at Le Meridien Hotel, Thursday.
Dr Gunasegaran, one of only two neurosurgeons in Sabah, attributed the head injuries to falls, road accidents, accidents at construction sites, violence and sports.
"Head injury cases linked to violence are not many.
The big chunk of our cases comes from accidents and construction sites.
These are the two groups of people who end up in our neurosurgical care."
According to him, road traffic accidents account for 60pc of head injury cases, mostly involving motorcycles.
"The bulk of our work at the QEH Neuro Centre is handling head injuries.
We also manage neurosurgical patients in Sandakan and Tawau. Other than QEH, the only three other hospitals with CT (Computerised Tomography) Scan facilities are in Keningau, Tawau and Sandakan.
"However, Keningau Hospital can't perform operations on patients with head injury and are sent to QEH. Likewise, Labuan, which has no CT Scan facilities, sends its patients to us.
"Tawau and Sandakan Hospitals can manage some of the head injury cases while the severe ones are transferred to QEH," he explained.
Dr Gunasegaran described the QEH Neuro Centre as being on call every day for almost all neurosurgical cases for the whole of Sabah.
"Most of the cases are referred to us, except for the mild ones.
Based on the patient's history and CT Scan which we (QEH Neuro Centre) can view from here, we can decide on what to do.
"Through TeleMedicine, we advise the district doctors whether they can observe the patient and perform the surgery there or send the patient over to us for surgery."
Offering advice to the district doctors, Dr Gunasegaran said basically, they must prevent secondary injury to the brain.
"We can actually prevent this. Severity of injuries on admission predicts the outcome or prognosis of the case. A major determinant of the outcome is the primary injury which is irreversible.
"As such, the doctors must make sure they minimise secondary insult to the brain," he cautioned.
District doctors, he said, can achieve this by managing their patients with all the head injury protocols available.
"Attend to the patient fast, stabilise the patient and refer the case to us very quickly.
That way, we will not lose the patient."
On delays in transferring patients to QEH Neuro Centre, Dr Gunasegaran said these could occur due to non-availability of flights or road conditions that can hamper fast transfer.
