Update information
May 2023: We have reviewed the evidence on pre-hospital interventions, assessment and management in the emergency department, and discharge and follow up, including follow up of people with a head injury and normal scans for deterioration. These recommendations are marked [2023].
We have also made some changes without an evidence review:
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For recommendations [2003, amended 2023], [2007, amended 2023] and [2014, amended 2023], we have made changes that could affect the intent without reviewing the evidence.
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For recommendations ending [2003], [2007], [2014], [2003, amended 2007], [2003, amended 2014] and [2003, amended 2007 and 2014], we have not reviewed the evidence. In some cases, minor changes have been made (for example, to update links, or bring the language and style up to date) without changing the intent of the recommendation.
Minor changes since publication
March 2025: We removed the link to NICE technology appraisal guidance on andexanet alfa (TA697) from recommendation 1.5.13 because the guidance has been updated and no longer applies to this guideline.
October 2023: We added definitions of closed head injury and penetrating head injury to clarify that this guideline covers both types of head injury.
August 2023: We amended recommendation 1.5.12 to make it clear that the 4-hour timeframe for observation is from the time of injury. We also added links to the MHRA safety advice on DOAC reversal and NICE technology appraisal guidance 697 on andexanet alfa to recommendation 1.5.13.
July 2023: In recommendations 1.2.3 and 1.2.4, we clarified that risk factors can include either current anticoagulant or antiplatelet treatment.
ISBN: 978-1-4731-5026-3