Neurosurgical Pack — Emergency Referral & Management
Created by
Abid Nisar
Specialty
Emergency Medicine
Last edited
4/6/2026
Uses
0 times
Tags
About this workflow
Generates a comprehensive neurosurgical emergency management pack: ABCDE assessment, NICE NG176-compliant CT indications, ICP management bundle, anticoagulation reversal, and SBAR-structured neurosurgical referral for TBI, intracranial haemorrhage, or spinal injury.
Preview
INDICATION [REQUIRED — Not a neurosurgical emergency] [REQUIRED: Specify clear neurosurgical indication (e.g. TBI/SAH/ICH/SDH/EDH/Suspected spinal cord injury/Raised ICP/Posterior fossa/brainstem emergency)]
PRIMARY SURVEY (ABCDE) A: [REQUIRED] | C-spine immobilised: [REQUIRED] B: RR [REQUIRED] | SpO2 [REQUIRED]% | Target: SpO2 >94%, PaCO2 4.5-5.0 kPa C: HR [REQUIRED] | BP [REQUIRED]/[REQUIRED] | MAP [REQUIRED] | Target: MAP >=80 mmHg in TBI (CPP >=60) D: GCS [REQUIRED] (E__V__M__) | Pupils: R [REQUIRED] mm [react/fixed] | L [REQUIRED] mm [react/fixed] | Focal deficit: [REQUIRED] E: Temp [REQUIRED] | Other injuries: [REQUIRED]
CT IMAGING DECISION (NICE NG176 — Indicate IMMEDIATELY if any present) GCS <13 at initial assessment | GCS <15 at 2h | Suspected open/depressed skull # Basal skull # signs (haemotympanum / panda eyes / CSF leak / Battle's sign) Post-traumatic seizure | Focal neurology | >1 episode vomiting Age >=65 + LOC or amnesia | Coagulopathy + LOC CT ordered: [REQUIRED] | Result: [REQUIRED] Midline shift: [REQUIRED] mm | Haematoma: [type + volume] | Herniation: [REQUIRED]
ICP MANAGEMENT BUNDLE [REQUIRED: Indication for ICP bundle not provided or suspected]
ANTICOAGULATION REVERSAL [REQUIRED: Patient anticoagulation/bleeding status]
NEUROSURGICAL REFERRAL (SBAR) S: [Name | Age | DOB | Location | Calling clinician name/grade/bleep] B: [MOI / presentation / co-morbidities / anticoagulants / GCS timeline] A: [GCS / pupils / CT findings / MAP / key positives] R: [Urgency: IMMEDIATE/URGENT/ROUTINE | Transfer: Yes/No | Specific question] Accepting consultant: [REQUIRED] | Time: [REQUIRED] | Receiving unit: [REQUIRED]
SPINAL PRECAUTIONS If spinal injury suspected: C-spine immobilisation (manual inline stabilisation preferred over hard collar in TBI) Log-roll | Avoid hypotension (MAP >=85 for 7 days in complete injury per RCS) Methylprednisolone: NOT recommended in acute traumatic SCI per current UK guidance.
[No evidence of neurosurgical emergency in the data provided — please clarify indication.]
How to use this workflow
This workflow runs as the ordered steps shown above. It gathers the information it needs, works through each step, and checks with you where the design asks it to. To add it to your account, simply click the “Use Workflow” button above; you can then adjust any step before running it. If you have any questions or need assistance, feel free to reach out to the support team or refer to the description and example output provided above.