Objective: To evaluate the impact of a French guideline on the clinical management of severe head injury (SHI) published in 1999.
Study design: Nationwide survey.
Methods: 182 medical centres answered the inquiry.
Results: 111 centres declared to manage such patients suffering from SHI. 68% of doctors from these clinical departments did report to have read these guidelines. Fifty percent of them found in these guidelines useful data for their clinical practice. Forty four percent of centres could not monitor ICP lacking neurosurgical facility in their hospital. Conversely, all hospitals with neurosurgery available did monitor ICP. Seventy six percent of centres reported difficulties to find a facility, which would take these patients in charge when discharged from ICU. We analysed the main items included in the guidelines and report their impact. Seventy four percent of responders found that clinical management of SHI patients had improved during the last years.
Conclusion: The French guidelines had a significant impact and seem to have provided a useful aid to clinical management of SHI patients. ICP monitoring and the shortage in post-ICU facilities are remaining issues.